Practical considerations for monitoring patients with chronic myeloid leukemia

Current routine monitoring strategies for chronic myeloid leukemia (CML) incorporate hematologic, cytogenetic, and molecular analysis. BCR-ABL1 kinase domain mutation analysis is an important assessment in specific circumstances. The recommendations for when and how frequently to undertake these assessments have recently been updated. However, response assessment is not always straightforward and access to some analytical tools may not be available. Pharmacokinetic assessment of imatinib levels may correlate with clinical response and could help in assessing issues of suboptimal response, excessive toxicity, or noncompliance. Here we provide practical considerations for monitoring response, offer suggestions for alternative assessments in case of failure or limited access of analyses, and consider future monitoring tools.