{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:46:43Z","timestamp":1789958803291,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,7,23]],"date-time":"2013-07-23T00:00:00Z","timestamp":1374537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:p>Second generation tyrosine kinase\u2010inhibitors (TKI) have been claimed to represent now the first\u2010choice therapy for chronic myeloid leukemia (CML). Indeed, they generally induce faster and deeper molecular responses compared to imatinib that, however, is equally effective in at least 50% of patients. Moreover, some recent reports have questioned the long term safety of dasatinib and nilotinib. Therefore, upfront imatinib with early shift to second generation TKI for patients with slow\/incomplete response might be as effective as front\u2010line second generation TKI, with a possibly better safety profile. We retrospectively evaluated 91 chronic phase CML patients (median follow\u2010up 57 months, median age 61 years), treated front\u2010line with standard\u2010dose imatinib and early therapy modifications (at 3\u201312 months) in case of unsatisfactory response or intolerance. Thirty\u2010three patients (24 with unsatisfactory response, 9 intolerant) changed therapy, either by increasing imatinib dose (11\/91) or by switching to second generation TKI (22 directly, 4 after high\u2010dose imatinib). Globally, our strategy led to complete cytogenetic response (CCyR) in 98% of the patients, major molecular response (MMR) in 88% and molecular response 4 logs (MR<jats:sup>4.0<\/jats:sup>) in 62%. Three patients in CCyR (3%), 2 of them in MMR too, suddenly progressed to blastic phase. At the last follow\u2010up nine patients had died, seven of CML\u2010unrelated causes and two only of CML progression. These results suggest that our strategy could be as effective as front line second generation TKI, with most of patients still receiving imatinib, a drug of better known long\u2010term side effects and lower cost. Am. J. Hematol. 88:838\u2013842, 2013. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23501","type":"journal-article","created":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T15:36:12Z","timestamp":1370964972000},"page":"838-842","source":"Crossref","is-referenced-by-count":7,"title":["Excellent therapeutic results achieved in chronic myeloid leukemia patients with front\u2010line imatinib and early treatment modifications in suboptimal responders: A retrospective study on 91 unselected patients"],"prefix":"10.1002","volume":"88","author":[{"given":"Marco","family":"Cerrano","sequence":"first","affiliation":[{"name":"Hematology Division Universit\u00e0 degli Studi di Torino Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cris\u00e0","sequence":"additional","affiliation":[{"name":"Hematology Division Universit\u00e0 degli Studi di Torino Turin 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