Imatinib, newer TKIs and the need for long-term studies
An interesting article about the long-term outcome of patients on imatinib in the 'real world' has been published. A study of 832 CML patients from around the world, who started imatinib before 2005, was conducted by Carlo Gambacorti-Passerini (Monza, Italy). There were few CML-related deaths in this large group of patients. Although we know that many patients do not remain on imatinib after several years it seems that imatinib continues to be an excellent treatment for most patients with CML.

An accompanying commentary notes that imatinib should perhaps still be considered the first line therapy of choice whilst 'waiting for more complete long-term toxicity and efficacy profiles of the second-line agents'. SPIRIT 2 is the only current CML study with long-term (5 year) survival as the primary endpoint.

Poor adherence, loss of CCyR and imatinib failure for CML patients
This article describes the relation between adherence to imatinib and the probabilities of losing a complete cytogenetic response and of imatinib failure in 87 CML patients receiving long-term therapy.  The authors have shown that poor adherence is the principal factor contributing to the loss of cytogenetic responses and treatment failure in patients on long-term therapy.