Imatinib (IM) failure and/or intolerance in the fi rst line treatment of patients with chronic myelogenous leukemia (CML) is an indication to change strategy into the higher doses of IM or second generation tyrosine kinase inhibitors (TKI). The main cause of treatment failure is BCR-ABL1 mutation and patient’s nonadherence. The patient presented in this case was initially treated with standard dose of IM and after 3 months complete hematologic response (CHR) and complete cytogenetic response (CCyR) were achieved. After 6 months since then cytogenetic failure was observed. The presence of BCR-ABL1 mutation was revealed. Then, therapy with nilotinib was introduced and CHR, CCyR and major molecular response were again achieved.
chronic myelogenous leukemia, BCR-ABL1 gene mutations, treatment failure, imatinib, nilotinib
BCR-ABL1 gene mutations