The European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia (CML) emphasize the importance of achieving a stable deep molecular response (DMR) and treatment-free remission (TFR). First-line treatment is a tyrosine kinase inhibitor (TKI), with generic imatinib being the most cost-effective option for chronic phase (CP) CML. TKIs should be selected based on efficacy, tolerability, toxicity, and cost. The new EUTOS long-term survival (ELTS) score is used to assess patient risk at diagnosis. Molecular response is monitored using quantitative PCR, and treatment changes are recommended if molecular milestones are not met. A BCR-ABL1 level of >10% at 3 months indicates treatment failure. Allogeneic stem cell transplantation remains an option for advanced-phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR to achieve TFR. The recommendations are based on high-quality evidence and consensus from an international panel of experts. The panel includes 34 experts from Europe, America, and the Asian-Pacific regions. The recommendations are aimed at healthcare professionals and patients to improve understanding of CML and its treatment. The definitions of hematologic, cytogenetic, and molecular responses are maintained from previous versions. The ELTS score is recommended for baseline prognostic assessment, with the Sokal score being less effective in TKI-treated patients. The panel recommends the use of the ELTS score for baseline prognostic assessment. Prognostic scores at baseline for CP CML and the comparison of Sokal and ELTS scores are shown in Table 2. A score calculator is available online. Additional risk factors, such as high-risk additional chromosome abnormalities (ACA), are considered. The panel recommends classifying ACA and treating patients with high-risk ACA as high-risk patients. Molecular response is assessed using the International Scale (IS) based on the ratio of BCR-ABL1 transcripts to ABL1 transcripts. The optimal response for TFR is BCR-ABL1 ≤ 0.01%. A change of treatment may be considered if MMR is not reached by 36–48 months. The panel recommends the use of the IS for monitoring milestones. The definitions of response to treatment and milestones are consistent with previous recommendations. First-line treatment includes imatinib, dasatinib, nilotinib, and bosutinib. Imatinib is the first-generation TKI, while dasatinib, nilotinib, and bosutinib are second-generation TKIs. Imatinib is the most cost-effective initial treatment for CP CML. Dasatinib, nilotinib, and bosutinib have been tested against imatinib in randomized trials. The panel recommends the use of the ELTS score for baseline prognostic assessment. TheThe European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia (CML) emphasize the importance of achieving a stable deep molecular response (DMR) and treatment-free remission (TFR). First-line treatment is a tyrosine kinase inhibitor (TKI), with generic imatinib being the most cost-effective option for chronic phase (CP) CML. TKIs should be selected based on efficacy, tolerability, toxicity, and cost. The new EUTOS long-term survival (ELTS) score is used to assess patient risk at diagnosis. Molecular response is monitored using quantitative PCR, and treatment changes are recommended if molecular milestones are not met. A BCR-ABL1 level of >10% at 3 months indicates treatment failure. Allogeneic stem cell transplantation remains an option for advanced-phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR to achieve TFR. The recommendations are based on high-quality evidence and consensus from an international panel of experts. The panel includes 34 experts from Europe, America, and the Asian-Pacific regions. The recommendations are aimed at healthcare professionals and patients to improve understanding of CML and its treatment. The definitions of hematologic, cytogenetic, and molecular responses are maintained from previous versions. The ELTS score is recommended for baseline prognostic assessment, with the Sokal score being less effective in TKI-treated patients. The panel recommends the use of the ELTS score for baseline prognostic assessment. Prognostic scores at baseline for CP CML and the comparison of Sokal and ELTS scores are shown in Table 2. A score calculator is available online. Additional risk factors, such as high-risk additional chromosome abnormalities (ACA), are considered. The panel recommends classifying ACA and treating patients with high-risk ACA as high-risk patients. Molecular response is assessed using the International Scale (IS) based on the ratio of BCR-ABL1 transcripts to ABL1 transcripts. The optimal response for TFR is BCR-ABL1 ≤ 0.01%. A change of treatment may be considered if MMR is not reached by 36–48 months. The panel recommends the use of the IS for monitoring milestones. The definitions of response to treatment and milestones are consistent with previous recommendations. First-line treatment includes imatinib, dasatinib, nilotinib, and bosutinib. Imatinib is the first-generation TKI, while dasatinib, nilotinib, and bosutinib are second-generation TKIs. Imatinib is the most cost-effective initial treatment for CP CML. Dasatinib, nilotinib, and bosutinib have been tested against imatinib in randomized trials. The panel recommends the use of the ELTS score for baseline prognostic assessment. The