Table 1 Clinically relevant TKI toxicities and reduced dose schedules.

TKI	Common side effects	Toxicities to watch for	^aProhibitive toxicities	^bLowest dose range
Imatinib	Rash, fluid retention, edema, weight gain, musculoskeletal aches, diarrhea, skin depigmentation	Renal toxicity	Neurotoxicity	100–200 mg/day
Nilotinib	Rash, headaches, increased bilirubin, impaired glycemic control, dyslipidemia	Renal toxicity, pancreatitis, Worsening diabetes	Arterio-occlusive and vaso-occlusive events	200 mg/day–200 mg BID
Dasatinib	Pleural effusion, cytopenia	Pulmonary hypertension, systemic hypertension	>1 episode of pleural effusion, pulmonary hypertension	20–50 mg/day
^cBosutinib	Gastrointestinal toxicity (diarrhea/colitis), renal dysfunction, liver dysfunction	Enterocolitis	Enterocolitis	100–200 mg/day
Ponatinib	Rash, hypertension	Pancreatitis, hepatic toxicity	Arterio-occlusive and vaso-occlusive events; refractory hypertension	15 mg/day

TKI tyrosine kinase inhibitor, BID twice daily.
^aClinical pancreatitis is a prohibitive toxicity that can occur with all TKIs, though most common with nilotinib and ponatinib.
^bLowest dose-range is a dynamic therapy decision that depends on the burden of the symptoms, any patient comorbidity that could be additive to the toxicity, and the state of CML disease control.
^cFor bosutinib a slow dose escalation over 3–4 months (100 mg/day x 1–2 weeks, 200 mg/day x 2–4 weeks, 300 mg/day x 1 month) to reach the final dose of 400 mg/day or 500 mg/day might ameliorate the gastrointestinal toxicities.

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