{
  "abstract": "Chronic-phase chronic myeloid leukemia (CP-CML) is currently treated with tyrosine kinase inhibitors (TKIs), and the early achievement of cytogenetic and molecular milestones is strongly associated with improved clinical outcomes. Here, we describe the case of a 55-year-old woman diagnosed with CP-CML in 2002 who received sequential TKI therapy for more than 20 years. Despite continuous treatment, she never achieved a complete cytogenetic response (CCyR) or a major molecular response (MMR), and the BCR::ABL1IS transcript levels remained above 10% for most of the disease course. At diagnosis, she presented with high-risk features, including p190 BCR::ABL1 transcript expression, and exhibited multiple mutations, but not driver ones, over time. Nevertheless, along with several TKIs treatments, she maintained a stable chronic-phase disease with sustained hematologic control and preserved a good quality of life throughout long-term follow-up. This case highlights the biological heterogeneity of CML, the timing and trajectory of BCR::ABL1-driven disease, the importance of patient-centered outcomes and the role of TKI therapy in maintaining durable hematologic remission and long-term disease control, even in the absence of optimal molecular milestones.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Hematology, AOU Policlinico “Rodolico - S. Marco”, University of Catania, Catania, Italy",
    "Department of Clinical and Experimental Medicine, University of Catania, Catania, 95123 Italy",
    "Center of Experimental Oncology and Hematology, A.O.U. Policlinico “G. Rodolico-S. Marco”, Catania, 95123 Italy",
    "Provincial Health Agency of Ragusa, Ragusa, RG Italy",
    "Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, 95123 Italy",
    "Hematology Section, AOU Policlinico “G. Martino”, University of Messina, via Consolare Valeria 1, Messina, 98124 Italy",
    "Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, 98124 Italy"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ermelinda Longo"
    },
    {
      "affs": [
        0
      ],
      "name": "Uros Markovic"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Stefania Stella"
    },
    {
      "affs": [
        3
      ],
      "name": "Agostino Antolino"
    },
    {
      "affs": [
        1,
        4
      ],
      "name": "Michele Massimino"
    },
    {
      "affs": [
        5
      ],
      "name": "Manlio Fazio"
    },
    {
      "affs": [
        0
      ],
      "name": "Francesco Di Raimondo"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Alessandro Allegra"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Fabio Stagno",
      "orcid": "0000-0002-7947-158X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5w216yy78z4e2.bib",
  "cited_by": 0,
  "doi": "10.1007/s00277-026-07233-4",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736373/",
  "id": "5w216yy78z4e2",
  "issns": [
    "0939-5555",
    "1432-0584"
  ],
  "landing_url": "https://doi.org/10.1007/s00277-026-07233-4",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2720|Chronic Myeloid Leukemia Treatments"
    ]
  ],
  "openalex": "W7202049109",
  "pdf_url": null,
  "pmcid": "PMC13736373",
  "pmid": "42983022",
  "published": "2026-08-10",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5w216yy78z4e2.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:50Z",
      "native_id": "PMC13736373",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00277-026-07233-4"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Chronic Myeloid Leukemia Treatments",
      "subfield": "general"
    }
  ],
  "title": "Prolonged indolent clinical course in a high-risk chronic phase-CML patient without cytogenetic or molecular response: a case challenging established response paradigms",
  "title_text": "Prolonged indolent clinical course in a high-risk chronic phase-CML patient without cytogenetic or molecular response: a case challenging established response paradigms",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:50Z",
  "url": "https://research.draconitic.com/paper/5w216yy78z4e2",
  "venue": "Annals of Hematology",
  "versions": []
}