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In this cessation study, we investigated the optimal conditions for dasatinib discontinuation in patients who maintained DMR for \u22652\u00a0years. This study included 54\u00a0patients with CML who were enrolled in a D\u2010STOP multicenter prospective trial, had achieved DMR, and had discontinued dasatinib after 2\u2010year consolidation. Peripheral lymphocyte profiles were analyzed by flow cytometry. The estimated 12\u2010month treatment\u2010free survival (TFS) was 62.9% (95% confidence interval: 48.5%\u201074.2%). During dasatinib consolidation, the percentage of total lymphocytes and numbers of CD3<jats:sup>\u2212<\/jats:sup> CD56<jats:sup>+<\/jats:sup> natural killer (NK) cells, CD16<jats:sup>+<\/jats:sup> CD56<jats:sup>+<\/jats:sup> NK cells and CD56<jats:sup>+<\/jats:sup> CD57<jats:sup>+<\/jats:sup> NK\u2010large granular lymphocytes (LGL) were significantly higher in patients with molecular relapse after discontinuation but remained unchanged in patients without molecular relapse for &gt;7\u00a0months. At the end of consolidation, patients whose total lymphocytes comprised &lt;41% CD3<jats:sup>\u2212<\/jats:sup> CD56<jats:sup>+<\/jats:sup> NK cells, &lt;35% CD16<jats:sup>+<\/jats:sup> CD56<jats:sup>+<\/jats:sup> NK cells, or &lt;27% CD56<jats:sup>+<\/jats:sup> CD57<jats:sup>+<\/jats:sup> NK\u2010LGL cells had higher TFS relative to other patients (77% vs 18%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0008; 76% vs 10%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001; 84% vs 46%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0059, respectively). The increase in the number of these NK cells occurred only during dasatinib consolidation. In patients with DMR, dasatinib discontinuation after 2\u2010year consolidation can lead to high TFS. This outcome depends significantly on a smaller increase in NK cells during dasatinib consolidation.<\/jats:p>","DOI":"10.1111\/cas.13430","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T15:22:06Z","timestamp":1508772126000},"page":"182-192","source":"Crossref","is-referenced-by-count":60,"title":["Dasatinib cessation after deep molecular response exceeding 2 years and natural killer cell transition during dasatinib consolidation"],"prefix":"10.1111","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6850-4545","authenticated-orcid":false,"given":"Takashi","family":"Kumagai","sequence":"first","affiliation":[{"name":"Department of Hematology Ome Municipal General Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiaki","family":"Nakaseko","sequence":"additional","affiliation":[{"name":"Department of Hematology Chiba University Hospital Chiba 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