Revisiting Treatment-free Remission: A Case of Late Molecular Recurrence in Chronic Myeloid Leukemia

We present the case of a woman in her early 70s with chronic-phase chronic myeloid leukemia (CML-CP), initially diagnosed in 2002. After achieving deep molecular response (DMR) with imatinib for over a decade, the patient discontinued treatment, entering treatment-free remission (TFR) for around 7 years. She later presented with fever, fatigue, and abnormal blood counts. Restarting imatinib led to a near-complete molecular response, emphasizing the potential for late molecular recurrence (LMRec) in TFR, and underscoring the importance of long-term monitoring in CML patients who discontinue tyrosine kinase inhibitor (TKI) therapy.