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In this single\u2010centre, retrospective cum prospective study of pCML in chronic phase, we report our experience of treating 173 children with imatinib and following them for long\u2010term toxicities. Mean (SD) time to attain CHR, CCyR and MMR were 3.05 (2.1), 10.6 (8.4) and 43.4 (31.8) months respectively. DMR was not attained in 59 (34%) patients at last follow\u2010up. Ten patients were switched to second\u2010generation TKIs (2G\u2010TKIs; nilotinib\u2009=\u20091\/dasatinib\u2009=\u20099) due to poor\/loss in response, of which seven had kinase domain mutations. Three patients progressed to the blastic phase. At a median follow\u2010up of 84 (3\u2013261) months, the 5\u2010year EFS and OS for the entire cohort were 96.9% (95% CI: 93.4\u2013100) and 98.7% (95% CI: 96.9\u2013100) respectively. Screening for long\u2010term toxicities revealed low bone density and hypovitaminosis D in 70% and 80% respectively. Other late effects included short stature (27%), delayed puberty (15%), poor sperm quality (43%) and miscellaneous endocrinopathies (8%). Children younger than 5\u2009years at diagnosis were more susceptible to growth and endocrine toxicities (<jats:italic>p<\/jats:italic>\u2009=\u20090.009). Regular monitoring for long\u2010term toxicities, timely intervention and trial of discontinuation whenever feasible are likely to improve the long\u2010term outlook of pCML.<\/jats:p>","DOI":"10.1111\/bjh.19251","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T05:58:34Z","timestamp":1702619914000},"page":"1249-1261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Treatment and follow\u2010up of children with chronic myeloid leukaemia in chronic phase (<scp>CML\u2010CP<\/scp>) in the tyrosine kinase inhibitor (<scp>TKI<\/scp>) era\u2014Two decades of experience from the Tata Memorial Hospital paediatric <scp>CML<\/scp> (<scp>pCML<\/scp>) cohort"],"prefix":"10.1111","volume":"204","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-3115","authenticated-orcid":false,"given":"Nirmalya","family":"Roy\u00a0Moulik","sequence":"first","affiliation":[{"name":"Pediatric Oncology 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