Initial Therapy in Previously Untreated Patients with Chronic Myelogenous Leukemia in Chronic Phase

The prognosis of patients with chronic myeloid leukemia (CML) has markedly changed since the introduction of tyrosine kinase inhibitors. Currently, imatinib is the only Food and Drug Administration–approved tyrosine kinase inhibitor for the treatment of patients with newly diagnosed CML. With imatinib 400 mg, an estimated 83% of patients are expected to be alive without disease progression, after a median follow-up of 60 months. Although this survival figure is higher than for any other previous therapy in CML, there is still room for improvement. To improve on these results, various approaches in the therapy of newly diagnosed patients with CML were studied. Of these, high-dose imatinib, or one of the new tyrosine kinase inhibitors, ie, nilotinib or dasatinib, shows promise. Our aim is to review the results of various studies using different approaches in the therapy of patients with newly diagnosed CML.