Letter
Author: Jing, Yu ; Han, Yan-Qiu ; Huang, Jian ; Weng, Jian-Yu ; Liang, Rong ; Pan, Ling ; Zhou, Ze-Ping ; Liu, Zhuo-Gang ; Huang, Xiao-Jun ; Li, Fei ; Sun, Zhi-Qiang ; Xiao, Zhen ; Yang, Yun-Fan ; Li, Wei-Ming ; Meng, Li ; Zhang, Xiaoshuai ; Zheng, Yuan-Jun ; Du, Xin ; Meng, Jun-Xia ; Hu, Jian-da ; Liu, Bing-Cheng ; Xu, Na ; Zeng, Yun ; Zhang, Yan-Li ; Liu, Chun-Shui ; Lin, Li-E ; Zhu, Huan-Ling ; Li, Guo-Hui ; Qiu, Hui-Ying ; Yang, Sen ; Zhang, Wei-Hua ; Yang, Wei ; Liu, Xiao-Li ; Yi, Hai ; Wang, Xiao-Dong ; Feng, Ru ; Chen, Chun-Yan ; Bai, Yan-Liang ; Liu, Zhen-Fang ; Zhao, Yan-Hong ; Jiang, Qian ; Jia, Zhi-Lin ; Chen, Su-Ning ; Yang, Li-Jie ; Sun, Xiu-Li ; Wu, Shi-Xin ; Zhang, Yan-Qing ; Gale, Robert Peter ; Liu, Yi-Lan ; Luo, Jian-Min
Nowadays, imatinib and second generation tyrosine kinase inhibitors (2G-TKIs) as initial therapy are used in newly-diagnosed chronic myeloid leukemia (CML) present in the accelerated phase.At the last follow-up, 166 subjects in the imatinib cohort (62%) and 121 in the 2G-TKI cohort (74%) remained on their first TKI.With a median follow-up of 39 (IQR, 18-73) months. 382 (90%) subjects achieved complete hematol. response (CHR) in 3 mo.In the cohort of subjects with basophils ≥20%, 127 subjects received imatinib and 82 received a 2G-TKI. 21 (17%) and 15 (18%) had a grade 3/4 hematol. AEs.Both the 2G-TKI and imatinib cohorts included subjects receiving branded and generic drug versions.In summary, we found no advantage in outcomes using a 2G-TKI in persons with CML initially presenting in an accelerated phase compared with imatinib except for better mol. response in subjects with basophils >20%.In some instances, there was a disadvantage seemingly reflecting 2G-TKI-associated dose interruptions and/or discontinuations because of hematol. AEs.Our conclusions need validation in a randomized controlled trial but may help physicians choose the best initial TKI therapy for subjects with CML initially presenting in the accelerated phase.