{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:22:15Z","timestamp":1793892135786,"version":"4.8.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Achieving major molecular response (MMR) with BCR::ABL1 tyrosine kinase inhibitors (TKIs) is associated with lower chances of progression to advanced phase disease and higher chances of treatment\u2010free remission (TFR) in patients with chronic myeloid leukemia (CML). Failure to achieve this molecular milestone after 1 year has been highlighted as \u201csuboptimal\u201d or \u201cwarning\u201d sign of treatment failure in CML guidelines and recommendations and implied to predict a poor long\u2010term outcome. In this analysis, we report the long\u2010term outcome of 131 patients who did not achieve MMR within the first 2\u2009years of TKI therapy. Patients who achieved a major cytogenetic response (MCyR; roughly equivalent to <jats:italic>BCR::ABL1<\/jats:italic> transcript levels on the International Scale [IS] &lt;10%) had good long\u2010term overall survival (OS) (10\u2010year OS of 88%) and CML\u2010related overall survival (CML\u2010OS) (10\u2010year CML\u2010OS of 95%). The achievement of MCyR within the first 2\u2009years of treatment predicted a better OS (HR\u00a0=\u00a00.43, <jats:italic>p<\/jats:italic>\u00a0=\u2009.03). The value of MMR was even less pronounced among patients aged 60\u2009years or older at diagnosis, in whom mortality was primarily due to comorbidities unrelated to CML (10\u2010year OS of 55% vs. 10\u2010year CML\u2010OS of 100%). In conclusion, achievement of MCyR within 2\u2009years is a reasonable milestone in CML, and these patients can still have good outcomes even when MMR is not achieved.<\/jats:p>","DOI":"10.1002\/ajh.26836","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T12:58:10Z","timestamp":1673009890000},"page":"639-644","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Chronic myeloid leukemia without major molecular response after 2\u2009years of treatment with tyrosine kinase inhibitor"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-5926","authenticated-orcid":false,"given":"Aram","family":"Bidikian","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas 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