Imatinib (IM) has dramatically improved the prognosis of chronic myeloid leukemia patients. Unfortunately, 30% of the patients will have to discontinue IM first-line treatment because of failure or intolerance. Second-generation tyrosine-kinase inhibitors, for example nilotinib, dasatinib, and the not yet licensed bosutinib, have been evaluated in phase II clinical trials in this setting. With a median follow-up of at least 24months, most of the responses are sustained while the safety profile of the three drugs appears acceptable but clearly different between the drugs. This review focuses on the available data regarding the efficacy and the safety profile of the three drugs.
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