How is resistance to or intolerance of first-line TKIs monitored and addressed in chronic myelogenous leukemia (CML) treatment?

Updated: Oct 23, 2019
  • Author: Rossa Khalaf, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Response to TKI is monitored. If desired milestones are not achieved, evaluation for patient compliance, consideration of a new drug interaction, and mutation analysis are recommended. If intolerance or inadequate response is confirmed, the treatment options are based on the first-line TKI that was used, as follows:

  • If there is intolerance or inadequate response to imatinib, other TKIs that can be used are dasatinib, nilotinib, or bosutinib.
  • If there is intolerance or inadequate response to dasatinib, other TKIs that can be used are nilotinib or bosutinib.
  • If there is intolerance or inadequate response to nilotinib, other TKI options are dasatinib or bosutinib

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