Effect Of Different Types Of Tyrosine Kinase Inhibitors On Response Of Chronic Myeloid Leukemia'S Patient In Single Institution In Upper Egypt

Content: 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. Objective: Retrospective study to determine the response of CML patients to imatinib and nilotinib as a second line of TKIS. Design: The study done from 2014 to 2016. Setting: Records of CML patients who attended Assiut University Clinical Hematology Unit and Clinical Oncology Unit. Patients and Methods: Evaluation of 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 from 400mg to 800mg and nilotinib from 600mg to 800mg or shifting to the other line. Interventions and Main Outcomes: Patients were revised and evaluated for complete hematological response, partial cytogenetic response (PCR), complete cytogenetic response (CCR), and major molecular response (MMR). Results: Administration of nilotinib 600mg/day or 800 mg/day achieved a higher percentage of MMR than imatinib (p= 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.