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Created by: Artur C. Fassoni, Maximilian Strobl

Issue 314: The advent of targeted therapy with Tyrosine Kinase Inhibitors (TKIs) has changed the paradigm for Chronic Myeloid Leukemia, with most patients achieving remission after a few years of treatment. Currently, the goal of clinical research is to predict which patients can safely discontinue TKI without relapse, relying on the immune system to control the residual leukemic cells that remain after discontinuation. Mathematical models are useful tools to characterize the dynamics of tumor-immune interactions in CML and to describe the post-treatment states in terms of attractors. In a recent model, we showed that three stable states can coexist, meaning that tumor elimination, control, or relapse are possible outcomes depending on the patient's immune system and treatment schedule. This figure shows an artistic representation for the complex, infinite-dimensional space corresponding to the 'real model' (reality) with trajectories describing different outcomes: red for relapse, yellow for tumor control, and green for tumor elimination. Figure created with Shakker.