Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia

What has NICE said?

Dasatinib (Sprycel) and nilotinib (Tasigna) are recommended as possible treatments for chronic- or accelerated-phase Philadelphia-chromosome-positive chronic myeloid leukaemia in adults if they can't have imatinib or their disease has got worse after treatment with imatinib.

High doses of imatinib (Glivec) are not recommended for treating Philadelphia-chromosome-positive chronic myeloid leukaemia in the chronic, accelerated or blast-crisis phase that has got worse after treatment with standard doses of imatinib.

What does this mean for me?

If you have chronic myeloid leukaemia, and your doctor thinks that dasatinib or nilotinib is the right treatment, you should be able to have it on the NHS.

High-dose imatinib should not normally be prescribed on the NHS for Philadelphia-chromosome-positive chronic myeloid leukaemia in the chronic phase (when most people are diagnosed), and accelerated or blast-crisis phase that has got worse after treatment with standard-dose imatinib. Your doctor should talk to you about other treatment options available to you. If you are already taking high-dose imatinib for this condition, you should be able to continue taking it until you and your doctor decide it is the right time to stop.

The condition and the treatments

Chronic myeloid leukaemia is a cancer of a type of white blood cell (called myeloid cells). These cells multiply in an uncontrolled way and stop other blood cells working properly. There are 3 main stages or 'phases' of the disease: the chronic, the accelerated and the blast-crisis phases. Most people with chronic myeloid leukaemia have an abnormal chromosome called the Philadelphia chromosome in their cancer cells (known as Philadelphia-chromosome-positive disease).

Dasatinib, imatinib and nilotinib stop cancer cells growing and multiplying. This slows down or stops the spread of the cancer.

NHS Choices may be a good place to find out more.

These organisations can give you advice and support:

NICE is not responsible for the quality or accuracy of any information or advice provided by these organisations.

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