Stopping Tyrosine Kinase Inhibitors in Affecting Treatment-Free Remission in Patients With Chronic Phase Chronic Myeloid Leukemia

Inclusion Criteria:

   - Patient must have been diagnosed with CML-CP at < 18 years of age.

   - Patient must have histologic verification of CML-CP at original diagnosis

   - Patient must be in molecular remission (MR) with a BCR-ABL1 level of =< 0.01% BCR-ABL1
   as measured using the International Scale (IS) by RQ-PCR for >= 2 consecutive years at
   the time of enrollment

      - Please note: The lab evaluating disease status and molecular response for this
      study must be College of American Pathology (CAP) and/or Clinical Laboratory
      Improvement Amendments (CLIA) certified (United States [US] only), sites in other
      countries must be certified by their accredited authorities. All labs must use
      the International Scale guidelines with a sensitivity of detection assay =< 0.01%
      BCR-ABL1 and be able to report results in =< 2 weeks

   - Patient must have received any TKI for a minimum of 3 consecutive years at time of
   enrollment

   - Patient agrees to discontinue TKI therapy

   - REGULATORY REQUIREMENTS

   - All patients and/or their parents or legal guardians must sign a written informed
   consent

   - All institutional, Food and Drug Administration (FDA), and National Cancer Institute
   (NCI) requirements for human studies must be met

   - ELIGIBILITY FOR PATIENT-REPORTED OUTCOMES (PROs):

   - Age >= 8 years at the time of enrollment

   - Ability to understand English or Spanish

   - Cognitive ability to complete instruments according to the primary team

   - ELIGIBILITY FOR AAML18P1 NEUROCOGNITIVE STUDY:

   - Patient must be 5 years or older at the time of enrollment

   - English-, French- or Spanish-speaking

   - No known history of neurodevelopmental disorder prior to diagnosis of CML (e.g., Down
   syndrome, Fragile X, William syndrome, mental retardation)

   - No significant visual or motor impairment that would prevent computer use or
   recognition of visual test stimuli

Exclusion Criteria:

   - Known T3151 mutation

   - Additional clonal chromosomal abnormalities in Philadelphia chromosome (Ph) positive
   (+) cells at any time prior to enrollment that include "major route" abnormalities
   (second Ph, trisomy 8, isochromosome 17q, trisomy 19), complex karyotype or
   abnormalities of 3q26.2

   - History of accelerated phase or blast crisis CML

   - Female patients who are pregnant

   - Lactating females are not eligible unless they have agreed not to breastfeed their
   infants

   - Female patients of childbearing potential are not eligible unless a negative pregnancy
   test result has been obtained