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Background: Chronic Myeloid Leukemia (CML) is a proliferative neoplasm with an incidence of one to two cases per 100,000 adults. It accounts for approximately 15% of newly diagnosed cases of leukemia in adults, it is a serious and life-threatening condition, but with the introduction of tyrosine kinase inhibitors, there is much better life expectancy with low incidence of mortality and morbidity. Aim of Study: Retrospective study to determine the response of CML patients to Imatinib and Nilotinib as a second lines of TKIS. Patients and Methods: Records of CML patients who attended Assiut University Clinical Hematology Unit and Clinical Oncology Unit from 2014 to 2016 were revised and evaluated for complete hematological response, Partial Cytogenetic Response (PCR), Complete Cytogenetic Response (CCR) and Major Molecular Response (MMR). The study evaluated the response of CML patients to two types of tyrosine kinase inhibitors; imatinib and Nilotinib as a second line therapy either by increasing the dose of imatinib 400mg to 800mg and Nilotinib 600mg to 800mg or shifting to the other line. Results: Administration of Nilotinib 600mg/day or 800 mg/day achieved a higher percentage of MMR than imatinib (p=<0.001). Conclusion: Nilotinib is a selective efficient second line TKI drug after failure or tolerance to Imatinib as it is more effective than imatinib as a second line therapy either by increasing the dose or shifting to it regarding MMR with a p-value 0.04. The development of TKIs has changed the natural history of CML patients with improvement in the overall survival and life style.

Response of Chronic Myeloid Leukemia's Patient to Different Types of Tyrosine Kinase Inhibitors