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Molecular remission is sustained in around 30% of imatinib\u2010treated patients who stop treatment after \u22652\u00a0years with undetectable minimal residual disease (<jats:styled-content style=\"fixed-case\">UMRD<\/jats:styled-content>) by conventional real\u2010time reverse transcription polymerase chain reaction. An additional 20\u201330% of patients will lose <jats:styled-content style=\"fixed-case\">UMRD<\/jats:styled-content>, but remain in stable major molecular remission off treatment. Most patients with molecular recurrence have a significant increase in <jats:italic><jats:styled-content style=\"fixed-case\">BCR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ABL<\/jats:styled-content>1<\/jats:italic> within the first 6\u00a0months off treatment, but there are also rare late relapses. As re\u2010treatment with imatinib restores control, a trial of <jats:styled-content style=\"fixed-case\">TFR<\/jats:styled-content> is safe so long as careful molecular monitoring is provided to enable prompt re\u2010treatment. The minimum eligibility criteria for a trial of <jats:styled-content style=\"fixed-case\">TFR<\/jats:styled-content> are not yet defined, but the available data support a <jats:styled-content style=\"fixed-case\">MRD<\/jats:styled-content> level of around a molecular response of 4\u00b75\u00a0log for at least 2\u00a0years. Factors associated with a higher probability of <jats:styled-content style=\"fixed-case\">TFR<\/jats:styled-content> include low risk Sokal score, prior interferon treatment, longer total duration of imatinib treatment and higher numbers of natural killer cells at the time of imatinib discontinuation. Preliminary data suggest that the rate of <jats:styled-content style=\"fixed-case\">TFR<\/jats:styled-content> in patients treated with more potent tyrosine kinase inhibitors will probably be higher. The biology that underlies <jats:styled-content style=\"fixed-case\">TFR<\/jats:styled-content> is an area of active investigation.<\/jats:p>","DOI":"10.1111\/bjh.12892","type":"journal-article","created":{"date-parts":[[2014,4,23]],"date-time":"2014-04-23T09:36:58Z","timestamp":1398245818000},"page":"3-11","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["How I determine if and when to recommend stopping tyrosine kinase inhibitor treatment for chronic myeloid leukaemia"],"prefix":"10.1111","volume":"166","author":[{"given":"David M.","family":"Ross","sequence":"first","affiliation":[{"name":"Haematology Directorate SA Pathology Adelaide SA Australia"},{"name":"School of Medicine University of Adelaide Adelaide SA Australia"},{"name":"Flinders University and Medical Centre Bedford Park SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy 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