OBJECTIVES: Initial treatment of chronic myeloid leukemia in chronic phase (CML-CP) is very important and tyrosine kinase inhibitors (TKIs) are effective to delay the progression of chronic phase in accelerated and blastic phase. Dasatinib and nilotinib have been compared to imatinib as first line treatments for CML in two recent randomised studies. However, no head to head evidence exists of the relative efficacy of dasatinib and nilotinib. The purpose of this study is to compare the clinical effects between the three targeted agents in CML patients. METHODS: We conducted a systematic review and used the data extracted to perform an indirect comparison meta-analysis of the three interventions. A random-effects approach was used to estimate the probability of response at each time point, and indirect comparison was implemented in the WinBUGS software packages. RESULTS: Data from nine clinical studies (3 trials) were included. The risk ratio of complete cytogenetic response (CCyR) and major molecular response (MMR) for dasatinib and nilotinib were significantly better than imatinib (CCyR and MMR at 6 months: 1.24 to 1.49 and 2.75 to 3.35; CCyR and MMR at 12 months: 1.18 to 1.23 and 1.50 to 1.99). A result of comparing the three TKIs of CCyR or MMR at 12 and 24 months’ follow-up through Bayesian indirect comparison nilotinib is the treatment showed a better response than the dasatinib (dasatinib vs. nilotinib at 24 months CCyR (95%CrI): 0.798 (0.300-0.986) vs. 0.844 (0.382-0.990); dasatinib vs. nilotinib at 24 months MMR (95%CrI): 0.604 (0.112-0.955) vs. 0.683 (0.173-0.970)).The overall survival and progression-free survival were not significantly different compared to the imatinib. CONCLUSIONS: On the basis of a systematic review of the current literature base, dasatinib and nilotinib should be viewed as dominant compared to imatinib. However, further clinical studies directly comparing nilotinib and dasatinib are required for more accurate comparisons between the three TKIs.