{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:08:26Z","timestamp":1788174506073,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T00:00:00Z","timestamp":1608768000000},"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":["Br J Haematol"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Targeted therapy for chronic myeloid leukaemia (CML) has allowed for a near\u2010normal patient life\u2010expectancy; however, quality of life and aggravation of existing co\u2010morbidities have posed new treatment challenges. In clinical practice, TKI dose reduction occurs frequently, often on multiple occasions, because of intolerance. We conducted a retrospective \u2018real\u2010world practice\u2019 review of 246 patients receiving lower than standard dose (LD) TKI after the achievement of major molecular response (MR3), because of intolerable adverse events. In 274 of 298 cases of dose reduction (91\u00b79%), MR3 was maintained at median follow\u2010up of 27\u00b73\u00a0months. One patient progressed to blast crisis while on LD TKI. Two patients developed two new ABL kinase domain mutations (T315I and V299L), of whom one had achieved deep molecular response on an alternative LD TKI at last follow\u2010up. Seventy\u2010six patients eventually discontinued LD TKI and the two\u2010year treatment\u2010free remission (TFR) rate in these patients was 74\u00b71%. The majority of patients with CML in at least MR3 appear to be safely managed with LD TKI, although three of 246 patients had new events (progression and new mutation), indicating that this approach requires vigilance. TKI LD does not prevent the achievement of TFR in this patient population.<\/jats:p>","DOI":"10.1111\/bjh.17286","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T03:58:43Z","timestamp":1608868723000},"page":"346-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["TKI dose reduction can effectively maintain major molecular remission in patients with chronic myeloid leukaemia"],"prefix":"10.1111","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-7610","authenticated-orcid":false,"given":"Simone","family":"Claudiani","sequence":"first","affiliation":[{"name":"Department of Haematology Hammersmith Hospital Imperial College Healthcare NHS Trust London UK"},{"name":"Centre for Haematology Department of Immunology and Inflammation Faculty of Medicine Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane F.","family":"Apperley","sequence":"additional","affiliation":[{"name":"Department of Haematology Hammersmith Hospital Imperial College Healthcare NHS Trust London UK"},{"name":"Centre for Haematology Department of Immunology and Inflammation Faculty of Medicine Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Szydlo","sequence":"additional","affiliation":[{"name":"Centre for Haematology Department of Immunology and Inflammation Faculty of Medicine Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afzal","family":"Khan","sequence":"additional","affiliation":[{"name":"Centre for Haematology Department of Immunology and Inflammation Faculty of Medicine Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7147-843X","authenticated-orcid":false,"given":"George","family":"Nesr","sequence":"additional","affiliation":[{"name":"Department of Haematology Hammersmith Hospital Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Hayden","sequence":"additional","affiliation":[{"name":"Imperial Molecular Pathology Hammersmith Hospital Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0918-8882","authenticated-orcid":false,"given":"Andrew","family":"J. 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