I have 2 HIV+CML and 1 HES FIP1 positive patients on Imatinib. Imatinib is well tolerated and all of these are in complete cytogenetic response. There are also some published evidence about a synergistic effect of HART and IM.

Out of a total of about 300 plus patients of CML on treatment at our center, 2 are HIV positive and are on HART.
Both are on Imatinib 400 mg/day and tolerating the well.
No experience with the 2nd Gen TKIs.
The problem for the patient is taking too many drugs per day leading to compliance issues.
Also, anemia, because of the ART or Imatinib, is an issue in these patients.
No other issues with toxicities or responses.

Good feedback
Thanks
Will start with imatinib and go from there.

We have treated 2 HIV positive patients. One continues on imatinib but has struggled with haematological toxicity and is on a reduced dose (from the Far East) and a second that failed imatinib, but has done very well on dasatinib. Both now have undetectable transcripts. I would favour imatinib first line in these patients.

I have treated two such patients with imatinib with good response and no problem of toxicity other than the usua one.

Whilst I haven’t had any CML patients who were also HIV+, I would favor IM for similar reasons as Tim