{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:40:18Z","timestamp":1781800818538,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T00:00:00Z","timestamp":1726876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970140"],"award-info":[{"award-number":["81970140"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100168"],"award-info":[{"award-number":["82100168"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In people with chronic\u2010phase chronic myeloid leukemia (CML) receiving imatinib and achieving major molecular response (MMR), dose reduction may decrease adverse events but may be associated with a loss of molecular response. Whether digital droplet polymerase chain reaction (ddPCR) can identify persons in whom dose reduction might be unsuccessful is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 716 consecutive subjects who achieved MMR after initial imatinib therapy (400 mg\/day) were obtained. A total of 486 subjects remained on full\u2010dose imatinib, whereas 230 subjects had their dose reduced to 300 or 200 mg\/day. The outcomes of these cohorts were compared via landmark and propensity score matching analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Imatinib dose reduction showed no significant effect on the subsequent achievement of deeper molecular responses (4\u2010 and 4.5\u2010log reductions in <jats:italic>BCR::ABL1<\/jats:italic> transcripts; MR<jats:sup>4<\/jats:sup> and MR<jats:sup>4.5<\/jats:sup>), maintenance of MMR, or attainment of therapy\u2010free remission when compared with subjects without dose reduction. In subjects achieving MR<jats:sup>4<\/jats:sup>, however, the probability of maintaining MR<jats:sup>4<\/jats:sup> (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.002) was lower in the reduced\u2010dose group. In multivariable analyses, failure to achieve MR<jats:sup>4.5<\/jats:sup> as determined by ddPCR at the time of dose reduction was significantly associated with briefer MMR failure\u2010free survival (FFS; hazard ratio [HR],\u00a010.3; 95% confidence interval [CI], 1.3\u201382.9; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03) and MR<jats:sup>4<\/jats:sup> FFS (HR,\u00a06.8; 95% CI, 2.6\u201318.0; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Imatinib dose reduction after achieving MMR does not adversely affect response deepening or MMR maintenance in chronic\u2010phase CML but compromises MR<jats:sup>4<\/jats:sup> maintenance. The results of ddPCR may identify people who benefit from imatinib dose reduction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35565","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T04:38:58Z","timestamp":1735792738000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Imatinib dose reduction after major molecular response in chronic\u2010phase chronic myeloid leukemia"],"prefix":"10.1002","volume":"131","author":[{"given":"Zongru","family":"Li","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Hematologic Disease Peking University Institute of Hematology Peking University People\u2019s Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshuai","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Disease Peking University Institute of Hematology Peking University People\u2019s Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijing","family":"Zhao","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Disease Peking University Institute of Hematology Peking University People\u2019s Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linping","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Tsinghua University  Beijing China"},{"name":"TargetingOne Corporation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Tsinghua University  Beijing China"},{"name":"TargetingOne Corporation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Peter","family":"Gale","sequence":"additional","affiliation":[{"name":"Department of Immunology and Inflammation Centre for Haematology Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazhen","family":"Qin","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Disease Peking University Institute of Hematology Peking University People\u2019s Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-0522","authenticated-orcid":false,"given":"Qian","family":"Jiang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Disease Peking University Institute of Hematology Peking University People\u2019s Hospital  Beijing China"},{"name":"Peking University People\u2019s Hospital  Qingdao 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