ABSTRACT
Current experience with the use of imatinib as primary therapy suggests that up to a third of all patients with chronic myeloid leukemia (CML) in chronic phase, and signifi cantly more in the advanced phase will require an alternative therapy within the fi rst two years of treatment. The long-term data following the use of a second-generation tyrosine kinase inhibitor (TKI), dasatinib or nilotinib, for fi rst-line therapy are not known at the present time, but the failure, although not necessarily the tolerance, is generally anticipated to be lower than that experienced with imatinib, but we cannot be sure at this time. It is, of course, of great clinical interest that the current results from randomized trials suggest better outcomes with both dasatinib and nilotinib, compared with standard dose imatinib, in particular the rates of major molecular responses (MMRs) and the event-free survival (EFS). Thus far, no differences in overall survival (OS) have been observed with either dasatinib or nilotinib.
