{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:13:31Z","timestamp":1769580811617,"version":"3.49.0"},"reference-count":61,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,3,4]],"date-time":"2016-03-04T00:00:00Z","timestamp":1457049600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chronic myeloid leukemia (CML) is rare among childhood leukemias. Its incidence increases with age, from 0.09\/100\u2009000 at \u226415\u2009years old to 7.88\/100\u2009000 at \u226575\u2009years old. There are several biological and clinical differences between pediatric and adult CML. Markedly increased leukocyte count and a higher incidence of splenomegaly are characteristic features at diagnosis in pediatric patients. The therapeutic approach to CML has changed since the introduction of the tyrosine kinase inhibitor (TKI) imatinib, followed by dasatinib and nilotinib. Given the efficacy of TKI in adult CML, TKI are regarded as the established first\u2010line treatment in adult patients. In 2011, a prospective phase IV study in pediatric patients showed the excellent efficacy and safety of imatinib. Imatinib is also accepted as a first\u2010line option for childhood chronic phase CML. Although the efficacy of dasatinib and nilotinib reported in adult studies seems very attractive for pediatric patients, neither drug has been prospectively investigated in a large pediatric cohort. TKI are designed to inhibit <jats:italic>BCR\u2010ABL1<\/jats:italic> kinase, but they have unfavorable effects, so\u2010called \u201coff\u2010target\u201d complications, such as growth impairment. Long\u2010term morbidity due to TKI is unknown. Furthermore, the adverse effects on growing children have not been clearly elucidated, even though the exposure period to imatinib is relatively short. To establish the standard therapeutic management for pediatric CML, it is important to prospectively confirm the attractive outcomes obtained in adult studies via pediatric clinical trials with a careful monitoring system for TKI\u2010induced adverse effects, especially in growing children.<\/jats:p>","DOI":"10.1111\/ped.12876","type":"journal-article","created":{"date-parts":[[2015,12,9]],"date-time":"2015-12-09T12:00:50Z","timestamp":1449662450000},"page":"171-179","source":"Crossref","is-referenced-by-count":24,"title":["Optimal management for pediatric chronic myeloid leukemia"],"prefix":"10.1111","volume":"58","author":[{"given":"Akihiko","family":"Tanizawa","sequence":"first","affiliation":[{"name":"Department of Human Resource Development for Cancer, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,4]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-05-501569"},{"key":"e_1_2_13_3_1","unstructured":"NCCN.Clinical Practice Guideline in Oncology Chronic Myelogenous Leukemia Version 1.2015. 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