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1. In our study the 5year DMR rate in 96 cml patients treated with imatinib was 80.2% .

In a
separate study performed in the United Kingdom, the 5-year cumulative MMR rate in 204
chronic phase cml patients treated with imatinib was 50.1%(de Lavadelle H, Apperley
JF, Khorashad JS, et al. Imatinib for newly diagnosed patients with chronic myeloid
leukemia: incidence of sustained responses in an intention-to-treat analysis. J Clin
Oncol 2008;26:3358–63).
2. In our study after 5 years of follow-up 9.1% of cml patients treated with nilotinib are not
receiving their initial therapy. In another study after 5 years of follow-up in the DASISION
trial(in the final report), 37% of those treated with imatinib are no longer receiving their
initial therapy(Cortes JE, Saglio G, Kantarjian HM, et al. Final 5-Year Study Results
of DASISION: The Dasatinib Versus Imatinib Study in Treatment-Naïve Chronic
Myeloid Leukemia Patients Trial. J Clin Oncol. 2016;34(20):2333-2340)
3. In our study after 5 years of follow-up 2% of cml patients among patients treated with
nilotinib are no longer receiving nilotinib.In another study the 5-year follow-up of the
ENESTnd study showed that 40% of patients treated with nilotinib 300 mg twice per day
and ,38% of those treated with 400mg twice per day had discontinued therapy(Hochhaus
A, Saglio G, Hughes TP, et al. Long – term benefits and risks of frontline nilotinib vs
imatinib for chronic myeloid leukemia in chronic phase: 5–year update of the
randomized ENESTnd trial. Leukemia. 2016;30(5):1044-1054). In both studies the drug
shifting from their front-line therapy was happen. The difference in percentage of drug
shifting in both studies may be due to difference in the sample size.
4. In our study 48.5% patients are on imatinib and 51.5% patients are on nilotinib. Among
the patients on imatinib 80.2% patients achieved DMR and among patients treated with
nilotinib 78.4%patients achieved DMR. We compare responses of both imatinib and
nilotinib statistically as initial therapy and found no statistical difference(p value 0.78).
Another study demonstrated that dasatinib, nilotinib and high-dose imatinib elicit very
similar treatment responses in patients treated first-line with these tyrosine kinase
inhibitors.(Adam Olshen, Min Tang, Jorge Cortes,3Mithat Gonen,Timothy
Hughes,Susan Branford, Alfonso Quintás-Cardama,and Franziska Michor,
Dynamics of chronic myeloid leukemia response to dasatinib, nilotinib, and high-dose
imatinib)
5. In another study 321 patients included in this analysis, 70% were imatinib resistant and
30% were imatinib intolerant. The 24-month follow-up results showed that Treating them
with nilotinib is effective as 59% of patients achieved MCyR and 44% of patients achieved
CCyR(Hagop M. Kantarjian, Francis J. Giles, Kapil N. Bhalla, Javier Pinilla-Ibarz,
RichardA. Larson, Norbert Gattermann, Oliver G. Ottmann, Andreas Hochhaus,
Jerald P. Radich, Giuseppe Saglio, Timothy P. Hughes, Giovanni Martinelli, Dong-
Wook Kim, Yaping Shou, Neil J. Gallagher, Rick Blakesley, Michele Baccarani, Jorge
Cortes,and Philipp D. le Coutre : Nilotinib is effective in patients with chronic myeloid
leukemia in chronic phase afterimatinibresistanceorintolerance:24-monthfollow-
upresults)
Note (for point 4):
 patients on imatinib as initial therapy for 5 year = 92(52.27%)
 patients on nilotinib as initial therapy for 5 year = 84(47.72%)
DMR achieved in patients on imatinib as initial therapy for 5 years?
DMR achieved in patients on nilotinib as initial therapy for 5 years?
Note (for point 5):
Patients shifted from first line to second line = 18
DMR achieved in Patients shifted from first line to second line?