Abstract
The discovery of imatinib was a major breakthrough in the therapy of chronic myeloid leukemia (CML). Therapy with imatinib yields very good treatment results in many patients, and is associated with low toxicity.
A large contribution to the therapy of patients resistant to imatinib as well as of patient who do not tolerate imatinib was the introduction of second-generation tyrosine kinase inhibitors (dasatinib, nilotinib) into clinical practice. Recently published results from dasatinib trials administered as first-line therapy in newly diagnosed patients with CML in chronic phase (CML-CP) demonstrated higher rates of optimum treatment response over 12 months, with shorter times to this response.
These results are thought-provoking and raise questions about what patients would most likely benefit from first-line therapy, and, on the other hand, what are the possible risks of this therapy.