Hematology 2017 Oct 9:1-9

Third-line treatment with second-generation tyrosine kinase inhibitors (dasatinib or nilotinib) in patients with chronic myeloid leukemia after two prior TKIs: real-life data on a single center experience along with the review of the literature.

Ongoren S1, Eskazan AE1, Suzan V2, Savci S2, Erdogan Ozunal I1, Berk S1, Yalniz FF1, Elverdi T1, Salihoglu A1, Erbilgin Y3, Iseri SA3, Ar MC1, Baslar Z1, Aydin Y1, Tuzuner N4, Ozbek U3, Soysal T1.
Newer tyrosine kinase inhibitors (TKIs) (bosutinib, ponatinib) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be utilized as a salvage therapy in patients with chronic myeloid leukemia (CML) who failed two lines (imatinib → nilotinib or imatinib → dasatinib) of TKI therapy. However, these TKIs are not available in many countries and not all patients can undergo allo-HSCT.
l="OBJECTIVES" NlmCategory="OBJECTIVE">Newer tyrosine kinase inhibitors (TKIs) (bosutinib, ponatinib) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be utilized as a salvage therapy in patients with chronic myeloid leukemia (CML) who failed two lines (imatinib → nilotinib or imatinib → dasatinib) of TKI therapy. However, these TKIs are not available in many countries and not all patients can undergo allo-HSCT.

METHODS:

In this study, CML patients who received dasatinib or nilotinib as a third-line treatment were retrospectively evaluated.

RESULTS:

Out of 209 patients, third-line dasatinib/nilotinib was administered in 21. During the follow-up, 16 out of 21 patients gained and/or maintained an optimal response, and 4 patients died due to progression. Seventeen patients were alive at the time of the analysis, of which 13 were still on TKI, whereas 4 patients quit treatment.

DISCUSSION:

In patients failing two lines of TKI, dasatinib or nilotinib can be beneficial and safely administered as a third-line treatment especially in nations with restricted resources.