HSCs and CMPs. A rise in BCR-ABL levels in GMP populations signified impending relapse. Post-SCT patients harbored more residual CML cells in CD34+ subpopulations than TKI-treated patients. Our findings suggest that in patients with persistent MRD-positivity post-SCT, the graft-versus-leukemia (GVL) effect may eliminate mature leukemic CD34+ subpopulations in vivo more readily. Primitive leukemic HSCs and CMPs, although persistent, are presumably constrained by GVL in patients who do not fulfill criteria for relapse. Conversely, TKI reduces the number of BCR-ABL-positive GMPs and CMPs more efficiently. Our data support adjuvant TKI-treatment for CML relapse post-SCT, and concurrent vaccination strategies which can target surface proteins on HSCs to eradicate CML.

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