Chinese patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) had a higher incidence of second malignancies, in contrast with the expected incidence among the general Chinese population, a study published in the journal Clinical Lymphoma, Myeloma & Leukemia has shown.1

TKIs revolutionized the treatment  of patients with CML by potentiating long-term survival. Most patients treated with TKIs have tolerated the agents satisfactorily, though the risk of second malignancies suggests that risk assessment is important.

Researchers evaluated the incidence and potential risk factors of second malignancies in 223 patients with Philadelphia chromosome-positive CML treated with a TKI, particularly imatinib. Investigators compared the data of second malignancies among patients with expected incidence from the National Central Cancer Registry of China.

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Results showed that after a median follow-up of 64 months from the time of CML diagnosis, 3.14% developed 6 distinct second malignancies, including breast, cervical, colon, gastric, kidney, and lymphonodus tissue. It was found that the risk of second malignancy was higher than expected with an observed-to-expected ratio of 2.45 (95% CI, 1.17-5.14; P = .018).

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Researchers were not able to identify potential risk factors, such as length of exposure or cumulative dose of TKI, that were associated with risk for development of a second malignancy in CML patients treated with imatinib.                              


  1. Yin X-F, Wang J-H, Li X, Yu M-X, Ma Z-X, Jin J. Incidence of second malignancies of chronic myeloid leukemia during treatment with tyrosine kinase inhibitors [published online ahead of print June 8, 2016]. Clin Lymphoma Myeloma Leuk. doi: 10.1016/j.clml.2016.06.010.