{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T20:42:51Z","timestamp":1781728971400,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T00:00:00Z","timestamp":1533600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["H23\u2010GanRinsho\u2010Ippan\u2010014"],"award-info":[{"award-number":["H23\u2010GanRinsho\u2010Ippan\u2010014"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP17ck0106329"],"award-info":[{"award-number":["JP17ck0106329"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The details of the sequential use of imatinib for first\u2010line treatment followed by second\u2010generation tyrosine kinase inhibitors (2G\u2010TKIs) for pediatric chronic myeloid leukemia (CML) are still unknown. This study analyzed clinical responses and adverse effects of the use of 2G\u2010TKIs following imatinib in pediatric chronic phase (CP)\u2010CML.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedures<\/jats:title><jats:p>The Japanese Pediatric Leukemia\/Lymphoma Study Group conducted a retrospective study of patients with newly diagnosed CML from 1996 to 2011. A total of 152 cases that received imatinib as first\u2010line therapy were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Excluding 46 cases treated with hematopoietic stem cell transplantation before nilotinib and dasatinib became available, 31 of 106 patients changed to 2G\u2010TKIs. The primary reason for changing from imatinib was poor response, followed by intolerance, with the main reason for the latter being musculoskeletal events. Switches from imatinib to 2G\u2010TKIs with intolerance occurred significantly earlier than switches with poor response. Sixteen and 15 patients were treated with nilotinib and dasatinib, respectively, following imatinib therapy. After switching to 2G\u2010TKIs, the response status improved in 63% of evaluable patients. The adverse effect profiles of nilotinib and dasatinib tended to be different, with hyperbilirubinemia observed in 33% of nilotinib\u2010treated patients, but in none of the cases with dasatinib.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This retrospective study represents the first series of children and adolescents in whom sequential use of imatinib followed by 2G\u2010TKIs was reported. These data provide useful insights into the selection of 2G\u2010TKIs as first\u2010line treatment for children and adolescents with CP\u2010CML.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27368","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T12:39:57Z","timestamp":1533645597000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sequential use of second\u2010generation tyrosine kinase inhibitors following imatinib therapy in pediatric chronic myeloid leukemia: A report from the Japanese Pediatric Leukemia\/Lymphoma Study Group"],"prefix":"10.1002","volume":"65","author":[{"given":"Hidemitsu","family":"Kurosawa","sequence":"first","affiliation":[{"name":"Department of Pediatrics Dokkyo Medical University School of Medicine  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0990-2508","authenticated-orcid":false,"given":"Akihiko","family":"Tanizawa","sequence":"additional","affiliation":[{"name":"Department of Human Resource Development for Cancer Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Muramatsu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikako","family":"Tono","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Iwate Prefectural Chubu Hospital  Iwate Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Niigata Cancer Center Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3432-8832","authenticated-orcid":false,"given":"Haruko","family":"Shima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Keio University School of Medicine  Tokyo Japan"},{"name":"Clinical Research Center National Hospital Organization Nagoya Medical Center  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Soma General Hospital  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Yuza","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuko","family":"Hamamoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hiroshima Red Cross Hospital &amp; 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