Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:First-line treatment for chronic myeloid leukemia: dasatinib, nilotinib, or imatinib | Wei et al. Journal of Hematology Oncology 2010 3 47 http content 3 1 47 JOURNAL OF HEMATOLOGY ONCOLOGY REVIEW Open Access First-line treatment for chronic myeloid leukemia dasatinib nilotinib or imatinib Guoqing Wei1 2 Shamudheen Rafiyath 2 Delong Liu2 Abstract Imatinib a tyrosine kinase inhibitor TKI of BCR-ABL was the standard first-line therapy for chronic myeloid leukemia CML for almost 10 years. Dasatinib and nilotinib two newer drugs with higher potency than imatinib against BCR-ABL and activity against most imatinib-resistant BCR-ABL mutations have each shown superior efficacy compared with imatinib for first-line treatment of chronic-phase CML in randomized phase 3 trials. With 14 months follow-up time available data suggest no obvious differences in efficacy between dasatinib and nilotinib. Compared with imatinib dasatinib is associated with higher rates of pleural effusion and thrombocytopenia but lower rates of edema gastrointestinal AEs musculoskeletal AEs and rash. Nilotinib is associated with higher rates of dermatologic toxicity headache and biochemical abnormalities associated with hepatic and pancreatic toxicity compared with imatinib but lower rates of edema gastrointestinal AEs muscle spasm and neutropenia. Several studies have shown that poor adherence to imatinib detrimentally affects responses and should be considered in patients with a suboptimal response. The different dosing requirements of dasatinib once daily with or without food and nilotinib twice daily with fasting may be an additional factor in selecting frontline agents. This review compares and contrasts the three FDA approved first line TKI agents. Introduction Imatinib which inhibits the tyrosine kinase activity of BCR-ABL was introduced as a first-line treatment for chronic myeloid leukemia CML almost 10 years ago and radically improved the outcome of patients with CML. Imatinib has been the standard therapy for CML due to its remarkable activity and mild .
