Efficacy of nilotinib in second line in an elderly patient with CML, suboptimal response and multiple comorbidities

In this case report we describe the clinical case of an elderly patient with chronic myeloid leukemia and multiple comorbidities (heart disease, diabetes). Following the diagnosis of CML, in 2005 the patient had started treatment with imatinib 400 mg / day; therapy was well tolerated and never suspended until 2011, when he comes to the attention of our center. After re-evaluation of the disease, the patient is considered "failure" according to the recommendations ELN 2009. For this reason he switched to second generation tyrosine kinase inhibitor, nilotinib. After just 3 months of treatment with nilotinib the patient gets a complete cytogenetic response and a reduction of the transcript BCR/ABL %IS from 0,85 to 0,004. These results are still maintained, without any influence on pre-existing conditions.