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Editor’s note: Patients with Philadelphia-positive acute lymphoblastic leukemia (Ph
+ ALL) or advanced phase chronic myeloid leukemia (CML) treated with second-generation tyrosine kinase inhibitors (TKI) often do not achieve a complete hematological response (CHR). In many cases, this is due to persistent cytopenias. Myelosuppression is a common problem associated with both dasatinib and nilotinib treatment; in patients with chronic-phase CML post-imatinib failure, neutropenia (grade 3/4) occurs in 50% and 30% of dasatinib and nilotinib recipients, respectively. As this discordance is likely to be due to TKI-induced cytopenia, it has been suggested that the achievement of a major cytogenetic response (MCyR) would be sufficient to favorably influence the long-term outcome of patients.