Imatinib cessation in children and adolescents with chronic myeloid leukemia in chronic phase.

Imatinib can be safely discontinued in adults with chronic myeloid leukemia (CML) where there is a prolonged complete molecular response (CMR). No data are available in the pediatric population. Six children with CML discontinued imatinib by themselves. Only three of them were in CMR but for <2 years. A significant increase in transcript level was observed in all six patients after cessation of imatinib and five patients lost the major molecular response (MMR). Four patients regained the MMR within 3 months. Cessation of imatinib in children is not recommended outside a trial, particularly in patients without prolonged CMR.