A 45-year-old man with CML is on imatinib and achieves complete cytogenetic response but NOT major molecular response at 12 months. BCR-ABL1 PCR shows 1.2% IS. According to ELN 2020 guidelines, this response is classified as:
- A Optimal response
- B Failure
- C Warning ✓
- D Suboptimal response
Correct answer: C. Warning
Explanation
ELN 2020 CML monitoring milestones define responses at 12 months as: Optimal = BCR-ABL1 ≤0.1% IS (MMR); Warning = BCR-ABL1 >0.1% to ≤1% IS (complete cytogenetic response but not MMR); Failure = BCR-ABL1 >1% IS at 12 months (which implies no complete cytogenetic response). At BCR-ABL1 1.2% IS the patient has complete cytogenetic response (CCyR) but NOT MMR — this falls into the Warning category, prompting closer monitoring but not mandatory TKI change.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.