Response of Chronic Myeloid Leukemia's Patient to Different Types of Tyrosine Kinase Inhibitors

Abstract
Background: Chronic Myeloid Leukemia (CML) is a proliferative neoplasm with an incidence of one to two cases per 100,000 adults. It accounts for approximately 15% of newly diagnosed cases of leukemia in adults, it is a serious and life-threatening condition, but with the introduction of tyrosine kinase inhibitors, there is much better life expectancy with low incidence of mortality and morbidity.
Aim of Study: Retrospective study to determine the re-sponse of CML patients to Imatinib and Nilotinib as a second lines of TKIS.
Patients and Methods: Records of CML patients who attended Assiut University Clinical Hematology Unit and Clinical Oncology Unit from 2014 to 2016 were revised and evaluated for complete hematological response, Partial Cy-togenetic Response (PCR), Complete Cytogenetic Response (CCR) and Major Molecular Response (MMR).
The study evaluated the response of CML patients to two types of tyrosine kinase inhibitors; imatinib and Nilotinib as a second line therapy either by increasing the dose of imatinib 400mg to 800mg and Nilotinib 600mg to 800mg or shifting to the other line.
Results: Administration of Nilotinib 600mg/day or 800 mg/day achieved a higher percentage of MMR than imatinib (p=<0.001).
Conclusion: Nilotinib is a selective efficient second line TKI drug after failure or tolerance to Imatinib as it is more effective than imatinib as a second line therapy either by increasing the dose or shifting to it regarding MMR with a p-value 0.04.
The development of TKIs has changed the natural history of CML patients with improvement in the overall survival and life style.