{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:08:08Z","timestamp":1784092088584,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Real-world data on tyrosine kinase inhibitor (TKI) use in chronic myeloid leukemia (CML) from the Middle East remain limited. We evaluated treatment patterns, molecular responses, treatment-free remission (TFR), and safety among Omani patients with chronic-phase CML.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective single-center study, adult patients (\u226518 years) with chronic-phase CML treated with TKIs between January 2008 and September 2024 were included. Demographics, Sokal risk, treatment lines, molecular responses, TFR, and adverse drug reactions (ADRs) were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 112 patients (mean age 43.7 \u00b1\u00a015.4 years), 45% had low Sokal risk, 43% intermediate, and 12% high risk. Imatinib was first-line therapy in 88.4%, achieving major molecular response (MMR) in 51%, with a median time to MMR of 21 months. In contrast, second-line TKIs demonstrated higher efficacy, with MMR rates of 79.2% for nilotinib and 54.4% for dasatinib, and shorter time to response (12 vs 23.2 months, respectively). Successful TFR was maintained in 17% of imatinib-treated patients after two years and in 83.3% of second-line patients after 36 months. ADRs were mainly gastrointestinal (28.5%), musculoskeletal (28.0%), dermatologic (20.8%), and hematologic (8.7%). Grade 3\u20134 events occurred in 5%, leading to TKI switching. Discontinuations were primarily due to loss of response, ADRs, or planned TFR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this real-world cohort, first-line imatinib provided acceptable but slower and less frequent molecular responses compared with second-generation TKIs. Higher TFR maintenance rates were observed with second-generation TKIs, although interpretation is limited by small patient numbers. These findings support a response-guided, risk-adapted approach to TKI selection and highlight the need to expand access to second-generation TKIs to optimize long-term outcomes in CML.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1866929","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:47:35Z","timestamp":1784090855000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment patterns and outcomes of tyrosine kinase inhibitors in chronic myeloid leukemia: a single center study from Oman"],"prefix":"10.3389","volume":"16","author":[{"given":"Noor","family":"Al-Rawahi","sequence":"first","affiliation":[{"name":"Pharmacy Department, University Medical City","place":["Muscat, Oman"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bushra","family":"Salman","sequence":"additional","affiliation":[{"name":"Pharmacy Department, University Medical City","place":["Muscat, Oman"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanalekshmi Unnikrishnan","family":"Meenakshi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, National University of Science and Technology","place":["Muscat, Oman"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murtadha","family":"Al-Khabori","sequence":"additional","affiliation":[{"name":"University Medical City","place":["Muscat, Oman"]},{"name":"Department of Hematology, Sultan Qaboos University","place":["Muscat, Oman"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al-Hanini","sequence":"additional","affiliation":[{"name":"University Medical City","place":["Muscat, Oman"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salam","family":"Al-Kindi","sequence":"additional","affiliation":[{"name":"University Medical City","place":["Muscat, 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