Imatinib mesylate and nilotinib decrease synthesis of bone matrix .

Tyrosine kinase inhibitors (TKIs), such as imatinib (IMA) and nilotinib (NIL), are the cornerstone of chronic myeloid leukemia (CML) treatment via the blockade of the oncogenic fusion protein. However, skeletal side effects are commonly observed in pediatric patients receiving long-term treatment with IMA. Additionally, studies have shown that IMA and NIL alter vitamin D metabolism, which may further impair bone metabolism.