[The challenge of achieving treatment-free remission for chronic myeloid leukemia]

While tyrosine kinase inhibitors (TKIs) have dramatically improved the prognosis for patients with chronic myeloid leukemia (CML), lifelong therapy presents challenges such as long-term toxicities and financial burden. Consequently, treatment-free remission (TFR) has become a primary therapeutic goal, with the aim of safely discontinuing TKIs while maintaining remission and enhancing patient quality of life (QoL). The feasibility and safety of TFR have been established through numerous clinical trials worldwide. The large-scale J-SKI observational study confirmed a 5-year TFR rate of 65.2% and demonstrated its safety in clinical practice. A sustained period of deep molecular response (DMR) is the most critical predictive factor for a successful TFR attempt. Current challenges include TKI withdrawal syndrome, the success of second TFR attempts, and the rare risk of blast crisis during TFR. Future strategies aim to increase TFR eligibility by achieving higher DMR rates with newer agents.