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Case Report

Mechanism of resistance to tyrosine kinase inhibitors - A case report and review

Dawnwin Joseph, Delcey Reachel Varghese, Raghuveer Prabhu, Anila K N.


This report aims to assess the viability of various challenging approaches such as tyrosine kinase inhibitors (TKIs) therapy, chemotherapy, and stem cell transplantation in patients with chronic myeloid leukemia (CML), especially for those in an advanced phase. Although standard treatments have been extremely effective in combating CML propagation and negating the disease symptoms along with an increased survival rate, these traditional treatment methods have experienced an increased failure rate due to TKI treatment resistance. A common mechanism that can be attributed to the increase in TKI resistance is the increasing mutations of the BCR-ABL 1 kinase domain. These mutations can be clearly observed in clinical trials. Currently, there are five BCR-ABL 1 kinase inhibitors that are approved for the safe treatment of CML. These are imatinib, dasatinib, nilotinib, bosutinib, and ponatinib. Mutational testing should be carried out on patients in such cases that show little response to traditional TKI therapy.In this report, we evaluate a patient who has been diagnosed with an accelerated phase CML and requires constant monitoring to tailor the treatment program to their requirements.

Key words: BCR-ABL; Chronic Myeloid Leukemia; Tyrosine Kinase Inhibitors; Imatinib

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