Abstract
Tyrosine kinase inhibitors (TKIs) are the mainstay of treatment in patients with chronic myeloid leukaemia (CML). Commonly available second-generation tyrosine kinase inhibitors (2G-TKIs) include nilotinib, dasatinib, and bosutinib. A majority of patients respond well to 2G-TKIs, yet some might develop resistance, intolerance, or both to the drugs. Based on the reason(s) for treatment failure, appropriate investigations should be arranged and therapeutic strategy should be formulated. In cases of intolerance, alternative 2G-TKI and imatinib are possible options if the issues cannot be resolved by temporary dose interruption and/or reduction and supportive care, with the co-morbidities and preferences of patients taken into account. On the other hand, alternative 2G-TKI and ponatinib are commonly considered in resistant cases. Recently, FDA-approved asciminib partially fills the treatment gap for patients who are resistant or intolerant to multiple TKIs, and is a much-welcomed addition to the artillery against CML. Allo-HSCT remains a standard salvage option for a small proportion of patients who fail all the above measures.
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Cheung Yuk Man, C. (2023). Treatment Options in CML Resistant or Intolerant to Second-Generation Tyrosine Kinase Inhibitors. In: Gill, H., Kwong, YL. (eds) Pathogenesis and Treatment of Leukemia. Springer, Singapore. https://doi.org/10.1007/978-981-99-3810-0_50
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DOI: https://doi.org/10.1007/978-981-99-3810-0_50
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