Tyrosine kinase inhibitor (TKI) selection for resistance or intolerance to the initial TKI in patients with chronic myeloid leukemia (CML) in chronic phase (CP)

2G: second generation; AEs: adverse effects; CML: chronic myeloid leukemia; CP: chronic phase; TK: tyrosine kinase; TKI: tyrosine kinase inhibitor.

* Grade ≥3 nonhematologic AEs despite symptom management and/or dose adjustment or other AEs that interfere with ongoing treatment.

¶ Confirm that the patient is adhering to the prescribed TKI regimen and avoiding medications or supplements that interfere with the TKI. Testing must be repeated to confirm an inadequate response or loss of response. Refer to related UpToDate material for hematologic, cytogenetic, and molecular response criteria to the initial TKI.

Δ Refer to related UpToDate material for the diagnostic criteria and management of advanced-stage CML.

◊ Refer to related UpToDate content for sensitivity of specific mutations to TKIs.