Determining Patient Eligibility for TFR

In clinical practice, eligibility for treatment discontinuation is broadly considered for all patients, as most individuals prefer not to be on lifelong therapy. However, decisions are tailored according to patient-specific factors such as age and comorbidities. For example, older patients with multiple health concerns might be managed more conservatively, often starting with first-generation therapies such as imatinib. Conversely, younger patients, especially those with significant life goals such as family planning, often receive more aggressive treatment approaches aimed at achieving deep remission and the possibility of stopping therapy. Despite this, many younger patients initially experience denial and hesitation about discontinuing treatment, highlighting the importance of ongoing counseling and education.

Patient preferences play a critical role in determining the timing and approach to treatment cessation. Although younger patients might be expected to pursue discontinuation more eagerly, some express apprehension due to concerns about disease relapse or the burden of more frequent monitoring. Similarly, older patients may also desire treatment-free remission (TFR) depending on their personal goals and quality-of-life considerations. Discussions about discontinuation are individualized, with health care providers encouraging patients to take the time they need to feel comfortable before making a decision. This patient-centered approach recognizes that readiness for treatment cessation varies widely and that maintaining open communication helps patients navigate their choices.

Ultimately, shared decision-making remains key. Physicians respect patient autonomy and acknowledge the psychological stress that can accompany attempts to stop therapy. Anxiety related to relapse risk and increased surveillance can influence patients’ comfort levels with discontinuation. Therefore, the decision to pursue TFR is not purely clinical but involves balancing medical eligibility with personal values, fears, and lifestyle. Ongoing dialogue and support help ensure that patients embark on this phase of care when they feel confident and prepared.