Treatment alternatives in newly diagnosed patients with chronic myeloid leukemia

The advent of imatinib has dramatically improved outcomes in patients with chronic myeloid leukemia (CML). It has become the standard of care for all patients with newly diagnosed disease based on its successful induction of durable responses in most patients. Recent studies have shown that second generation of tyrosine kinase inhibitors (TKI) nilotinib and dasatinib provide quicker and potentially better responses than standard-dose imatinib when used as a first-line treatment. The goal of CML therapy is the achievement of a major molecular response, to prevent disease progression to accelerated or blast phase. Selecting the appropriate TKI depends on many factors, including disease phase, side effect profile, relative effectiveness against Bcr-Abl mutations and the patient´s tolerance to therapy. This paper will provide treatment options in newly diagnosed patients with chronic phase CML. (author)