{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T23:50:17Z","timestamp":1773877817076,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Approximately half of patients with chronic myeloid leukemia (CML) who attempted tyrosine kinase inhibitor (TKI) discontinuation for the first time experienced molecular relapse and restarted TKIs. Although several studies have already investigated first treatment\u2010free remission (TFR) attempts (TFR1), few previously published articles have focused on the plausibility and predictors of second TFR (TFR2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To evaluate the feasibility and likelihood of TFR2 success in real\u2010life, 90 patients with CML regularly followed in 23 Italian hematological centers were analyzed; these patients reattempted TKI discontinuation after a first failed attempt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five (50.0%) patients lost major molecular response after a median of 4.0 months off therapy, whereas 45 (50.0%) remained treatment\u2010free for a median of 18.8 months. In univariate analysis, there was no association between TFR2 and the following variables: age, gender, Sokal risk score,\n                      <jats:italic>BCR::ABL1<\/jats:italic>\n                      transcript type, prior interferon exposure, type and number of previous TKIs, resistance to any prior TKIs, and TKI switching after TFR1. In contrast, factors identified as associated with TFR2 success included a lower ELTS risk score, a longer time from TFR1 to molecular relapse (\u22653 months), as well as a longer TKI treatment and deep molecular response (DMR) duration (\u22654 years) before TFR2.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While confirming the critical prognostic role of ELTS risk and TKI treatment and DMR duration even before TFR2, this real\u2010life study provides further information to support the safety of a second effort to discontinue TKIs in patients with CML, as a failed first attempt does not appear to preclude a second successful one.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70261","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:39:02Z","timestamp":1768999142000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Second attempt to discontinue TKI after molecular relapse in patients with chronic myeloid leukemia: A real\u2010life Italian multicenter study"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4401-0812","authenticated-orcid":false,"given":"Alessandra","family":"Iurlo","sequence":"first","affiliation":[{"name":"Hematology Division Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-023X","authenticated-orcid":false,"given":"Daniele","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Hematology Division Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico  Milano Italy"},{"name":"Department of Oncology and Hemato\u2010Oncology University of Milan  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Fava","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences University of Turin Mauriziano Hospital  Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Castagnetti","sequence":"additional","affiliation":[{"name":"Institute of Hematology \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-1686","authenticated-orcid":false,"given":"Massimiliano","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"Department of Medicine Section of Hematology University of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariella","family":"D\u2019Adda","sequence":"additional","affiliation":[{"name":"Hematology Unit, ASST Spedali Civili  Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Cristina","family":"Miggiano","sequence":"additional","affiliation":[{"name":"Division of Hematology San Bortolo Hospital  Vicenza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Capodanno","sequence":"additional","affiliation":[{"name":"Hematology Unit Azienda Unit\u00e0 Sanitaria Locale\u2010IRCCS  Reggio Emilia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Elena","sequence":"additional","affiliation":[{"name":"Unit of Molecular Hematology &amp; 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