skip to main content

CML Treatment Milestones — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardHaematologyCML Treatment MilestonesRACP Adult Medicine

A 62-year-old man with newly diagnosed chronic myeloid leukaemia in chronic phase is commenced on imatinib 400 mg daily. Three months later, BCR-ABL1 transcript level is 8% (IS). According to ELN 2020 milestones, what does this represent?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Warning – consider intensification

ELN 2020 milestones at 3 months: BCR-ABL1 ≤10% (IS) is optimal; >10% is failure. At 8%, this patient has achieved an optimal response at 3 months but is in the 'borderline optimal' range. Close monitoring at 6 months is essential – the target is BCR-ABL1 <1% (IS). If 6-month target is not met (BCR-ABL1 1–10%), it becomes a 'warning', and >10% at 6 months is failure requiring TKI switch.

Reference: eTG – 2025 – Haematology; ELN – 2020 – CML Management Recommendations