Evolution of the European LeukemiaNet recommendations for chronic myeloid leukemia.

[INTRODUCTION] Chronic myeloid leukemia (CML) management has been revolutionized by tyrosine kinase inhibitors (TKIs), leading to near-normal life expectancy for most patients diagnosed in the chronic phase. The European LeukemiaNet (ELN) recommendations provide the internationally recognized framework for the diagnosis, monitoring, and treatment of CML.

[AREAS COVERED] This review provides a chronological overview of the evolution of ELN recommendations for CML across five updates (2006, 2009, 2013, 2020, and 2025). Relevant literature published up to January 2026 was identified through a search of PubMed/MEDLINE, using keywords including 'chronic myeloid leukemia,' 'CML,' 'European LeukemiaNet,' 'ELN recommendations,' 'tyrosine kinase inhibitors,' and 'treatment-free remission.'

[EXPERT OPINION] Over time, ELN recommendations have shifted from cytogenetic to molecular monitoring, incorporated second-generation TKIs, and introduced treatment-free remission as a major therapeutic goal. The latest framework emphasizes personalized CML management by integrating molecular response with patient-specific factors, reflecting the broader evolution of precision medicine in hematology.