LI Xue 1 , LI Rui 2,3,4 , LI Meixuan 2,3,4 , HOU Liangying 2,3,4 , FU Jiani 3,4,5 , ZHANG Wenhao 3,4,6 , ZHAO Kun 1 , YANG Kehu 2,3,4
  • 1. China National Health Development Research Center, Beijing 100044, P.R.China;
  • 2. Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, P.R.China;
  • 3. Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, P.R.China;
  • 4. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, P.R.China;
  • 5. The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, P.R.China;
  • 6. The Second School of Clinical Medicine, Lanzhou University, Lanzhou 730000, P.R.China;
ZHAO Kun, Email: zk317@nhei.cn; YANG Kehu, Email: kehuyangebm2006@126.com
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Objective To systematically review the efficacy and safety of different tyrosine kinase inhibitors (TKIs) in the treatment of chronic myelocytic leukemia (CML).Methods PubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of nilotinib, dasatinib, flumatinib and imatinib for CML from inception to August, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, network meta-analysis was performed by using Stata 15.0 and R 3.4.0 software.Results A total of 8 RCTs involving 2 775 patients were included. Compared with other TKIs, flumatinib had higher 3-month early molecular response and 1-year progression free survival, and the incidence of serious side effects was relatively low. Major molecular response and complete cytogenetic response were significantly better than imatinib, and had the same or similar effec as other second-generation TKIs.Conclusion Current evidence shows that flumartinib in the treatment of CML obviously better than imatinib, has the same or similar effect with other second generation TKIs. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.