Next-generation sequencing for BCR-ABL1 kinase domain mutation testing in patients with chronic myeloid leukemia: a position paper

Table 2 Summary of the indications for the use of next-generation sequencing (NGS) for BCR-ABL1 KD mutation testing in chronic myeloid leukemia (CML)

Indications for the use of NGS testing in chronic phase CML
- in patients with failure^a response to TKI therapy, irrespective of the TKI
- in patients with warning^a response to TKI therapy, irrespective of the TKI
Indications for the use of NGS testing before allogeneic stem cell transplant (allo-SCT)
- BCR-ABL1 KD mutation status by NGS testing before allo-SCT may provide useful information regarding when post-transplant TKI therapy should be reinstated. Patients who do not have BCR-ABL1 KD mutation results by NGS available at the time of transplant should be tested^b
Indications for the use of NGS testing in advanced CML phases
- all patients with advanced phase (AP or BC) either at diagnosis or during therapy
Indications for the use of NGS testing after TKI therapy discontinuation
- in patients relapsing after a TFR attempt if they fail to re-achieve MMR within 3–6 months after TKI re-treatment

^aIt has to be noted that, at present, failure and warning definitions for third-line and beyond are lacking
^bProvided that BCR-ABL1 transcript levels are sufficient, i.e., > 0.1%^IS
AP accelerated phase, BC blast crisis, MMR major molecular response, TFR treatment-free remission, TKI tyrosine kinase inhibitor, IS International Scale

ISSN: 1756-8722