Nilotinib early switch efficacy in non-optimal responder CML patient after first line imatinib treatment

We report a case of a patient with chronic myeloid leukemia in chronic phase who was treated with Imatinib as first line therapy. He showed a suboptimal response by 2006 ELN criteria after six months, for this reason we performed a mutational analysis that showed the mutation F486S. Due to this finding we made an early switch to Nilotinib (Nil); patients started Nil at 300 bid mg/day obtaining at six month a complete cytogenetic response (CCyR) and a MMolR (RQ-PCR ratio BCR-ABL1/ABL1%IS: 0.05). The patient is now on 24 months Nil treatment showing a RQ-PCR ratio BCR-ABL1/ABL1%IS: 0.004