Treatment free remission (TFR) and PCR testing

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The tyrosine kinase inhibitor (TKI) imatinib was the first treatment to specifically target cancer cells, rather than the relatively indiscriminate effects of conventional chemotherapy on any rapidly dividing cells. This concept of targeted treatment in cancer is one of the important advances in modern medicine in the last 30 years. Indeed, treatment with TKIs has transformed chronic myeloid leukaemia (CML) from a cancer with a poor prognosis to one in which many patients can expect a normal lifespan. 

Success with the TKIs has prompted the question of whether it is desirable – or feasible – for patients to remain on treatment for long periods. While the TKIs are targeted, they are associated with considerable toxicity, and long-term treatment has important economic implications for health services and patients. Thus, the concept of treatment-free remission (TFR) has emerged for patients in deep clinical remission. Clinical research over the last decade has focused on whether treatment can be stopped, how to best monitor patients while off treatment, and how to intervene before a clinical relapse. As this research progresses, the tantalising prospect of a cure for some patients seems increasingly feasible.

This new e-learning course explains this trail-blazing approach to the long-term management of patients living with CML in remission. It explains the concepts of molecular and haematological relapse, the highly sensitive technologies that allow disease monitoring, and how TFR is best managed in practice. 

This concise educational resource is ideal for any healthcare professional involved in the treatment of patients with CML who wants to understand TFR, particularly clinical nurse specialists and pharmacists who increasingly help clinicians to run CML clinics.

For each chapter, we have produced a workbook that you can download and keep. The pass mark for this course is 70%.

Completion of this course will take approximately 4 hours (1 hour per chapter) and the certificates provided can be used towards your revalidation.

This course was commissioned by Leukaemia Care and written by Sandeep Potluri MB BChir(Cantab) MA(Cantab) MRCP for Karger publishing.


For any queries about the content of the TFR and PCR testing course, including references, please email

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