Co-morbidities in patients suffering from chronic myelogenous leukemia and tyrosine kinase inhibitor choice

Abstract

Tyrosine kinase inhibitors (TKI) have revolutionized the treatment of chronic myelogenous leukemia (CML). Reported cases of resistance to imatinib, the first inhibitor used in CML therapy, have now speeded up the research and development of second generation TKI. These have been used not only in second line treatment, but according to registration could be administered in a first-line setting, inducing more rapid and profound molecular responses compared to those rates in patients treated with imatinib. CML is most commonly diagnosed in patients aged in their 5th–6th decade, thus being in a patient group with a substantial incidence of co-morbidities. Choosing an optimal TKI should therefore be based on a thorough analysis of co-morbidities and toxicity profiles for any given TKI. This article describes and discusses selected and frequent clinical conditions, that could influence the decision making process for the optimal choice of CML therapy with TKI.