I agree almost completely with your proposal and I would continue the current TKI, monitoring every 3 months for molecular response and every 12 months for cytogenetic response (marrow cell metaphases, because there was a trisomy 8, although trisomy 8 can be seen also by FISH). It is unusual that a patient with stable CCyR does not achieve an MMR, with imatinib, and particularly with second generation TKIs. I understand that he’s compliant, but……..nobody knows! And there may be problems of drug absorption and metabolism. I suggest to contact your Novartis contact to plan a measurement of blood drug concentration. I suggest also to take care of the “cardiovascular” conditions, using the Edinburgh questionnaire for claudicatio, with a periodic evaluation of the ABI, and with an ultrasound evaluation of epiaortic vessels, and of some metabolic indicators like blood glucose, cholesterol and HDL. Best wishes, Michele