A safety review of tyrosine kinase inhibitors for chronic myeloid leukemia.

INTRODUCTION: Since the introduction of first tyrosine kinase inhibitor(TKI) imatinib, treatment of chronic myeloid leukemia (CML) has reachedexcellent survival expectancies. Long survival rates bring about issuesregarding TKI safety.

AREAS COVERED: The aim of this review is to compare the side effectsof current TKIs both in the first- and later lines and outline a safety andprofile of CML treatment. Seminal studies on TKIs and other newer drugs andextended follow-up of these studies, real-life data of each drug were usedduring the course of this. PubMed was used as a search database and onlyarticles in English were included.

EXPERT OPINION: With longer follow-up CML patients, resistant slowgrade adverse events seem to be the major obstacle in the way of treatmentefficacy. If efficacy is the priority, vigorous treatment of side effect andadministration of full dose TKI are reasonable. But when treatment goals arereached dose modifications or alternative treatment regimens may be acceptedpossible. More studies are needed on dose modification protocols and potentialbenefits and safety of treatment-free remission.