Preliminary Observation Of Second-generation Tyrosine Kinase Inhibitors In The Treatment Of Chronic Myelogenous Leukaemia

【Objective】To investigate the efficacy and adverse events of second-generation tyrosinekinase inhibitors(dasatinib,nilotinib) in the treatment of chronic myelogenousleukaemia.【Methods】The clinical datas of26CML patients receiving second-generation tyrosinekinase inhibitors(dasatinib,nilotinib) in the Institute of Hematology,Fujian MedicalUniversity Union Hospital from January2007to December2012were analyzedretrospectively.15patients received dasatinib treatment and11patients receivednilotinib treatment.The efficacy and adverse events of two TKIs will be assessedobjectively in this article.【Results】15patients received dasatinib treatment.9were CML-CP patients(3were newlydiagnosed,5were IM-resistant and1was IM-intolerant),3were CML-AP patients and3were CML-BC patients.9patients in CP all achieved CHR.6(6/9) patients in CPachieved CCyR,3were newly diagnosed and3were IM-resistant.3newly diagnosedpatients in CP all achieved CMR while only5received molecular detection ofCML-CP patients.3patients in AP all achieved CHR but only one achievedCCyR.Only1IM-resistant patient achieved CHR by3months of3patients in BC,butit died after losing CHR by9months.The estimated4-year OS was88.9%(8/9) of9patients in CP.1IM-resistant patient died by23months.The estimated4-year EFSwas77.8%(7/9) of9patients in CP.1IM-intolerant patient lost PCyR by18months.The estimated4-year OS,EFS were66.7%(2/3) and33.3%(1/3) of3patientsin AP respectively.3CML-BC patients all died before a follow-up time of9months.Adverse events related to dasatinib could be well managed.No one died ofserious adverse events. 11patients received nilotinib treatment.9were CML-CP patients(3were newlydiagnosed and6were IM-resistant) and2were CML-AP patients.9patients in CP allachieved CHR.4(4/9) patients in CP achieved CCyR,2were newly diagnosed and2were IM-resistant.4(4/9) patients in CP achieved CMR,2were newly diagnosed and2were IM-resistant.Only one achieved CHR of2IM-resistant patients in AP.Both twopatients in AP didn’t receive any cytology or molecular detection.The estimated1-yearOS was77.8%(7/9) of9patients in CP.2CML-CP patients died,one is newlydiagnosed and the other is IM-resistant.The estimated2-year EFS was55.6%(5/9) of9patients in CP.1newly diagnosed patient in CP and3IM-resistant patients in CPoccured death or disease progression.The overall survival of two CML-AP patients isboth6months,one having died in the study.Only one CML-CP patient occured grade3hematologic adverse events during follow-up time.No one discontinued therapy dueto the serious drug adverse events related to nilotinib.【Conclusion】Second-generation TKIs(dasatinib,nilotinib) are effective,safe and well toleratedin the treatment of chronic myelogenous leukaemia.