Obesity is a chronic disease that is increasing in prevalence in adults, adolescents, and children and it is now considered to be a global epidemic. Current recommendation for treatment of Chronic Myeloid Leukemia (CML) does not take in consideration the weight of the patient with regard to doses of different Tyrosine Kinase Inhibitors. Obesity and obesity related surgeries are emerging and unmet needs. To shed the light into this special category of patients and we provide a strategy to treat morbid obesity with CML as well as obesity related surgeries like gastric band, sleeve gastrectomy in patients with CML. Five case scenarios were used to illustrate what is seen in real life: CML (CP) with class III obesity, CML (CP) with sleeve Gastrectomy, CML (CP) post gastric band CML with blast crisis each scenario were followed by proposal for treatment. Obesity and obesity related surgeries are emerging and unmet needs, the treatment of each should be individualized, and the TKI dose may needs to be adjusted in certain categories. The morbidity and mortality associated with being overweight (body mass index [BMI] of 25-29.9 kg/m 2) or obese (BMI of ≥ 30 kg/m 2) have been known to the medical profession for more than 2000 years. Obesity is a chronic disease that is increasing in prevalence in adults, adolescents, and children and it is now considered to be a global epidemic. 1 Body mass index (BMI) based classifications were originally based upon the associated risks of cardiovascular disease (CVD). The recommended classifications for BMI, adopted by the National Institutes of Health (NIH) and World Health Organization (WHO), 2,3 for Caucasian, Hispanic, and black individuals are: Underweight-<18.5 kg/m 2 Normal weight-≥18.5 to 24.9 kg/m 2 Overweight-≥25.0 to 29.9 kg/m 2 Obesity-≥30 kg/m 2 Class I-30.0-34.9 kg/m 2 Class II-35.0-39.9 kg/m 2 Class III-≥40 kg/m 2 (also referred to as severe, extreme, or massive obesity)

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm classically described as triphasic disease: chronic, accelerated, and blast crisis. There are many unmet needs and unanswered questions about CML. Intermittent fasting in patients with CML on tyrosine kinase inhibitors is among these unmet needs. Here we report the effect of intermittent fasting on response to nilotinib as upfront in a 49-year-old female Muslim who fasted during Ramadan and took her medication once instead of twice daily and remained in major molecular response.

Background Obesity is a chronic disease that is increasing in prevalence in adults, adolescents, and children and it is now considered to be a global epidemic. Current recommendation for treatment of Chronic Myeloid Leukemia (CML) does not take in consideration the weight of the patient and doses ofTKIs How I treat obesity and obesity related surgery in patients with chronic myeloid leukemia: an outcome of an ELN project.