Experience using Imatinib and then Nilotinib, as second line, in patient with chronic myeloid leukemia and previous bariatric surgery. A case report

摘要

Chronic myeloid leukemia (CML) has become a model of suc- cess in the history of hematology. That is due to the possibility of discovering and monitoring the molecular basis of the dis- ease and blocking it by employing tyrosine kinase inhibitors (TKIs). 1 In the beginning of the XXI century, chemotherapy and the recombinant interferon-alpha were overcome by the efficiency of the TKIs in chronic-phase (CP) CML patients. Approximately 80% of the patients presenting CP-CML treated with imatinib achieved complete cytogenetic remission (CCR). Moreover, these patients also present extraordinary long sur- vival rates. Firstly, imatinib demonstrated that a fatal cancer could become a chronic comorbidity. Soon after the first generation of TKIs, owing to the development of imatinib- resistance, other TKIs were developed, such as: dasatinib, nilotinib, bosutinib and ponatinib.