Response of Second Generation Tyrosine Kinase Inhibitors in the Patients with CML at a Tertiary Care Hospital in the North Western India.

Introduction: Chronic myeloid leukemia is characterized by the dysregulated growth of granulocytes, driven by the Philadelphia chromosome translocation. The prevalence of CML is higher in men, with a median age of 57 years and a five-year survival rate of 85%. Tyrosine kinase inhibitors such as Imatinib have revolutionized CML treatment. However, resistance or intolerance to first-line Imatinib requires second-generation TKIs like Nilotinib and Dasatinib. This study aims to evaluate the response of patients treated with these TKIs at a hematology clinic. Methods: This retrospective study analyzed 100 randomly selected CML patients treated between 2020 and 2022. Data were collected on patient demographics, disease progression, treatment regimens, and response rates. Patients who started on Imatinib and later switched to second-line TKIs due to resistance or side effects were followed to assess treatment efficacy. Results: The cohort had a median age of 43 years, with 52% males and 48% females. Most patients (95%) initiated treatment with Imatinib, with 6% experiencing mild side effects and 4% severe side effects leading to treatment changes. In patients resistant to Imatinib, second-generation TKIs showed favorable responses: Dasatinib was effective in patients with advanced disease, while Nilotinib was useful for those intolerant to Imatinib. One patient resistant to both was successfully treated with Bosutinib, a third-generation TKI. Conclusion: Our findings highlight the efficacy of secondgeneration TKIs for managing Imatinib-resistant CML. Dasatinib and Nilotinib effectively managed disease progression, though side effects were a concern. The use of third-generation TKIs like Bosutinib provides additional therapeutic options for refractory cases. [ABSTRACT FROM AUTHOR]