EHA 2026 | Biological barriers preventing patients from achieving durable remission in CML
Timothy Hughes, MD, MBBS, FRACP, FRCPA, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia, comments on the challenge of achieving treatment-free remission (TFR) in chronic myeloid leukemia (CML), highlighting the persistence of leukemic stem cells and defects in immune control as major barriers. Prof. Hughes notes that the relative importance of these factors likely varies between patients and suggests that a patient-specific approach is needed to identify and target the limiting factor. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
We still have a major challenge in achieving treatment-free remission. Around about 30% of our patients can achieve it today, and there are probably two major barriers. That is persistence of leukemic stem cells that are capable of rapidly growing when the treatment stops, and some defect in the immune control. I think there’s evidence for both of those. Precisely what’s more important, it probably depends on the patient, and I think we need to identify in a sort of patient-specific sense what is the limiting factor and focus on therapies that can modify that, such as intensifying the therapy or modifying the immune system in some way to stimulate a better recognition of the remaining leukemic stem cells...
We still have a major challenge in achieving treatment-free remission. Around about 30% of our patients can achieve it today, and there are probably two major barriers. That is persistence of leukemic stem cells that are capable of rapidly growing when the treatment stops, and some defect in the immune control. I think there’s evidence for both of those. Precisely what’s more important, it probably depends on the patient, and I think we need to identify in a sort of patient-specific sense what is the limiting factor and focus on therapies that can modify that, such as intensifying the therapy or modifying the immune system in some way to stimulate a better recognition of the remaining leukemic stem cells. So I think we have a number of really effective predictors of TFR and we should use those to better understand how we can improve outcomes.
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