The long-term outcomes of imatinib treatment for chronic myeloid leukemia (CML) were analyzed in a 10.9-year follow-up study. Patients with newly diagnosed CML in the chronic phase were randomly assigned to receive either imatinib or interferon alfa plus cytarabine. Due to high crossover rates, the analysis focused on the imatinib group. At 10 years, the estimated overall survival rate was 83.3%, with 48.3% of patients completing treatment and 82.8% achieving complete cytogenetic response. Serious adverse events related to imatinib were uncommon and mostly occurred in the first year. Long-term administration of imatinib was not associated with unacceptable cumulative or late toxic effects. The study confirmed that imatinib's efficacy persisted over time, and its safety profile remained favorable. The trial significantly improved CML prognosis, leading to reduced mortality rates in the U.S. and other regions. Imatinib's ability to achieve deep molecular responses and its long-term safety make it a cornerstone of CML treatment. While newer tyrosine kinase inhibitors show promise, imatinib remains effective and safe for long-term use. The study highlights the importance of early treatment and the potential for treatment-free remission in patients with sustained deep molecular responses. The results underscore the clinical benefits of imatinib in CML over the past 15 years.The long-term outcomes of imatinib treatment for chronic myeloid leukemia (CML) were analyzed in a 10.9-year follow-up study. Patients with newly diagnosed CML in the chronic phase were randomly assigned to receive either imatinib or interferon alfa plus cytarabine. Due to high crossover rates, the analysis focused on the imatinib group. At 10 years, the estimated overall survival rate was 83.3%, with 48.3% of patients completing treatment and 82.8% achieving complete cytogenetic response. Serious adverse events related to imatinib were uncommon and mostly occurred in the first year. Long-term administration of imatinib was not associated with unacceptable cumulative or late toxic effects. The study confirmed that imatinib's efficacy persisted over time, and its safety profile remained favorable. The trial significantly improved CML prognosis, leading to reduced mortality rates in the U.S. and other regions. Imatinib's ability to achieve deep molecular responses and its long-term safety make it a cornerstone of CML treatment. While newer tyrosine kinase inhibitors show promise, imatinib remains effective and safe for long-term use. The study highlights the importance of early treatment and the potential for treatment-free remission in patients with sustained deep molecular responses. The results underscore the clinical benefits of imatinib in CML over the past 15 years.