The history of treatment of chronic myeloid leukemia (CML) is divided into pre Tyrosine kinase inhibitor era and post Tyrosine kinase inhibitor era. The discovery of Imatinib revolutionized the treatment of CML and the mortality and morbidity associated with CML and chemotherapy have considerably decreased. There has been search for more tyrosine kinase (TKI)inhibitor for the treatment of CML as first line drugs. Dasatinib and Nilotinib have come up.
It is considered that Nilotinib and Dasatinib can be used in Imatinib resistant CML. Nilotinib has been considered as 2nd line drug in the treatment till recent times. But latest trials have shown that Nilotinib is better than the legendary TKI Imatinib and Dasatinib in many aspects. It is safer,better tolerated and more efficacious drug than Imatinib and Dasatinib and clearly drug of choice in most patients with chronic phase CML.Recent article published in Indian Journal Of Cancer by Vaid A, Department of Medical Oncology,Cancer Institute,Medanta Hospital,Medicity,Gurgaon concludes that Nilotinib can be used as the first line therapy for chronic myeloid leukemia.
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