慢性期慢性髓性白血病患者接受甲磺酸伊马替尼一线治疗后，虽然大部分患者可显著获益，但仍有相当比例的患者不能获得满意疗效。如果患者未获得满意疗效，则依然存在疾病进展风险。因此，对于甲磺酸伊马替尼治疗失败或疗效欠佳的患者，需要考虑转换其他替代治疗，以得到最大获益。研究显示，甲磺酸伊马替尼治疗失败的患者换用第二代酪氨酸激酶抑制剂尼洛替尼治疗获益显著。本文就甲磺酸伊马替尼治疗失败的患者换用尼洛替尼的时机及疗效进行探讨。%Though most of CML-CP patients receiving imatinib mesylate as first-line therapy can get response, there were still quite a few patients who can not achieve optimal response, which means there are still risks of disease progression for them. Therefore, for patients who fail to imatinib mesylate therapy or only respond with suboptimal response, other alternative treatment should be taken into consideration to maximize the benefit of treatment. There has been data showing that CML patients failing to imatinib mesylate can get remarkable response when they switch to second generation TKI. The efficacy of nilotinib on CML patients failing or sub-optimally responding to imatinib is summarized and the right time for switch is discussed in this review.
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