Introducing Treatment-Free Remission (TFR) to Patients Early in Their Treatment Course for CP-CML

In modern clinical practice, addressing adverse events remains crucial, but a significant focus has shifted toward achieving TFR in patients with CML. From the very first consultation, it is important to introduce the concept that CML is a highly treatable and potentially functionally curable disease. This early framing helps patients maintain motivation and understand that managing the adverse effects of therapy is part of a larger goal: reaching a state where they might eventually discontinue treatment. Although detailed discussions about TFR timing and likelihood may be premature during initial visits, introducing the possibility offers hope and a clear target to work toward.

As patients progress through therapy, clinicians should monitor response closely and revisit conversations about TFR when patients demonstrate a strong likelihood of achieving deep molecular remission. Not all patients reach this stage quickly; some may experience slower responses or face complications that require adjustments in treatment or participation in clinical trials. Maintaining open communication and encouraging persistence are essential, as achieving remission can take years but remains possible for many. This approach helps patients stay engaged and committed to their therapy despite challenges or slow progress.

Selecting the appropriate tyrosine kinase inhibitor at treatment initiation should be guided by the patient’s individual clinical profile and long-term goals, including the potential to discontinue therapy. Understanding each patient’s “finish line” allows for personalized therapy that balances efficacy with tolerability and quality of life. Ultimately, early and clear communication about the goals of treatment, coupled with careful management of adverse events, support adherence and enhance the likelihood of successful remission and eventual treatment discontinuation.