Guidance on the use of imatinib for chronic myeloid leukaemia

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This is an extract from the guidance and may be misleading if read alone. The complete guidance is available at guidance.nice.org.uk/ta70

1 Guidance

This guidance replaces 'Imanitib for chronic myeloid leukaemia' (NICE technology appraisal guidance 50) issued in October 2002.

This guidance has been partially updated by the following NICE technology appraisal guidance:

Dasatinib, high-dose imatinib and nilotinib for the treatment of imatinib-resistant chronic myeloid leukaemia (CML) (part review of NICE technology appraisal guidance 70), and dasatinib and nilotinib for people with CML for whom treatment with imatinib has failed because of intolerance (NICE technology appraisal guidance 241)
Dasatinib, nilotinib and standard-dose imatinib for the first-line treatment of chronic myeloid leukaemia (part review of technology appraisal guidance 70) (NICE technology appraisal guidance 251)

1.1 This recommendation has been updated and replaced by NICE technology appraisal guidance 251.

1.2 Imatinib is recommended as an option for the treatment of people with Philadelphia-chromosome-positive chronic myeloid leukaemia (CML) who initially present in the accelerated phase or with blast crisis. Additionally, imatinib is recommended as an option for people who present in the chronic phase and then progress to the accelerated phase or blast crisis if they have not received imatinib previously.

1.3 This recommendation has been updated and replaced by NICE technology appraisal guidance 241.

1.4 For people in chronic-phase CML who are currently receiving interferon alpha (IFN-α) as first-line treatment, the decision about whether to change to imatinib should be informed by the response of the disease to current treatment and by the tolerance of the person to IFN-α. This decision should be made after informed discussion between the person with CML and the clinician responsible for treatment, taking full account of the evidence on the risks and benefits of imatinib and the wishes of the person.