The iCMLf TFR Alliance - Optimising Treatment Free Remission

While a cure for CML remains the ultimate goal, treatment free remission (TFR) is often the treatment target for those on TKI therapy. Still, with only around 50% of attempts resulting in sustained TFR, there is much room for improvement.

The iCMLf TFR Alliance brings global researchers together with the aim of ensuring more people with CML can stop therapy and sustain TFR.

In 2022 the iCMLf TFR Alliance partnered with the HARMONY Alliance for a TFR project: Use of big data to identify optimal treatment pathways leading to successful treatment-free remission in CML. The objective of this research project is to effectively evaluate a multitude of factors that may predict and influence a successful TKI discontinuation for patients with CML, allowing for a sustained TFR, which could potentially be linked to long-term cure of the disease. 

“By utilising the Harmony Big-Data Platform, and using pooled data from multiple contributors within the International CML Foundation Treatment-Free Remission Alliance, we plan to investigate key components and actions potentially influencing the outcome of TKI discontinuation.” (Torsten Dahlén, Project Lead)

Project status

As of February - 24 sites from 17 countries are enrolled to participate in the iCMLf/HARMONY TFR project. Thirteen sites have successfully uploaded data, and two sites have completed the process, including data upload, transfer to the platform, and mapping. The dataset currently comprises 215 available cases, with over 3,500 expected. First data analysis is anticipated in Q3 2024.

History of the iCMLf TFR Alliance: Establishing a global registry for TFR

Established in late 2019, the iCMLf TFR Alliance has now evolved into a global network of  41 collaborators from 21 countries aiming to enhance successful TFR attempts for people with CML.

In 2020 the TFR Alliance began the process to establish an International TFR Registry as an optimal way to study clinically (and pharmaco-economically) important research questions on treatment-free remission. Initial seed funding from the iCMLf Climb for a Cure was awarded to the Swedish CML Registry Group following a call for proposals. 

Torsten Dahlén (M.D.), Martin Höglund (M.D., PhD) and Leif Stenke (M.D., Professor) from the Swedish CML Registry Group lead the iCMLf TFR Alliance Registry project

Following a community survey to define the registry parameters and outcomes, priorities for the TFR registry were established and we moved to the 'set up’ phase.

In October 2020, HARMONY PLUS was launched. CML data could be accepted to the Big-Data platform and the iCMLf/HARMONY TFR project was proposed and accepted as the way to collate and analyse multinational TFR data.

HARMONY Plus platform – Big data to improve CML treatment

“Harnessing the power of pooled patient-level data we hope to identify the optimal treatment pathway leading to an increased likelihood of a successful, prolonged TFR, allowing for better guided clinical care” Torsten Dahlén

The HARMONY Big Data Project facilitates data pooling and sharing for specific hematologic malignancies with a central repository of data. Genomic and clinical data is collected from multiple research groups that contribute anonymised data in a secure way following all legal and ethical requirements.

HARMONY Plus is an extension to the project to expand the scope of data sharing to other hematologic malignancies, including CML. The HARMONY Plus project team is collaborating with the iCMLf TFR Alliance to facilitate the multi-country contribution of clinical and outcome CML data to the HARMONY data platform, to answer key clinical questions using Big Data. 

Make a difference in the fight against CML

You can donate to the iCMLf research projects by visiting our donation page to get involved and make a difference in the fight against CML.

We are grateful to Pfizer and Incyte for support for the analysis and publication of the iCMLf Alliance projects.