Underreported and underreviewed: Addressing the gaps in TKI tolerability literature for chronic myeloid leukemia

Tyrosine kinase inhibitors have transformed survival in chronic-phase chronic myeloid leukemia, yet long-term treatment success increasingly depends on treatment tolerability. Despite its recognized influence on adherence and quality of life, tolerability remains poorly defined and inconsistently addressed. To characterize existing review literature, a structured PubMed search identified review articles published between October 24, 2019, and October 23, 2024. Of 771 articles screened, 30 met inclusion criteria, 14 discussed tolerability in depth, and only 2 centered it as a primary theme. Definitions varied widely with no consensus across articles. Most reviews focused on toxicity or hospitalization, with limited coverage of low-grade, persistent adverse events or patient-reported outcomes. These findings highlight the absence of a unified understanding and prioritization of tolerability in the literature and underscore the need for a dedicated framework that clearly defines tolerability, distinguishes it from "lack of toxicity", and incorporates patient perspectives to better guide long-term CML care.