First-line therapy for chronic myeloid leukemia is:

First-line therapy for chronic myeloid leukemia is:

• A. Imatinib
• B. Dasatinib
• C. Nilotinib
• D. Hydroxyurea

Answer: (A)

Chronic myeloid leukemia is driven by the BCR-ABL fusion tyrosine kinase, so the main idea is to inhibit that driver to stop the leukemic cells from growing. Imatinib specifically blocks the BCR-ABL kinase by occupying its ATP-binding site, preventing phosphorylation and signaling that push the malignant clone to expand. This targeted approach leads to strong hematologic, cytogenetic, and molecular responses and has translated into improved survival. Because of its long track record and favorable balance of efficacy and safety, it became the standard first-line therapy. Hydroxyurea can lower blood counts quickly, but it doesn’t address the underlying BCR-ABL driver, so it’s used mainly for rapid cytoreduction or bridging therapy rather than as disease-modifying first-line treatment. The other tyrosine kinase inhibitors are effective and may be used after resistance or intolerance, and in some settings upfront, but imatinib remains the classic first-line option with the most supporting long-term outcomes.

Chronic myeloid leukemia is driven by the BCR-ABL fusion tyrosine kinase, so the main idea is to inhibit that driver to stop the leukemic cells from growing. Imatinib specifically blocks the BCR-ABL kinase by occupying its ATP-binding site, preventing phosphorylation and signaling that push the malignant clone to expand. This targeted approach leads to strong hematologic, cytogenetic, and molecular responses and has translated into improved survival. Because of its long track record and favorable balance of efficacy and safety, it became the standard first-line therapy.

Hydroxyurea can lower blood counts quickly, but it doesn’t address the underlying BCR-ABL driver, so it’s used mainly for rapid cytoreduction or bridging therapy rather than as disease-modifying first-line treatment. The other tyrosine kinase inhibitors are effective and may be used after resistance or intolerance, and in some settings upfront, but imatinib remains the classic first-line option with the most supporting long-term outcomes.