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Comment & Response
June 2016

Multiple Causes of Cardiotoxic Effects in Patients With Chronic Myeloid Leukemia

Author Affiliations
  • 1Department of Medicine, University of Arizona, Tucson
  • 2Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota
  • 3Arizona Cancer Center, University of Arizona, Tucson
  • 4Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson
JAMA Oncol. 2016;2(6):828-829. doi:10.1001/jamaoncol.2016.1005

To the Editor From a meta-analysis of 10 randomized trials comparing newer-generation tyrosine kinase inhibitors (TKIs) (nilotinib, dasatinib, bosutinib, and ponatinib) vs imatinib in patients with chronic myeloid leukemia (CML), Douxfils et al1 concluded that each newer-generation TKI is associated with an increased risk of vascular occlusive events. Although, to their credit, the authors performed supporting 1-way sensitivity analyses and the I2 values suggested homogeneity of studies included, we noticed a variation in vascular occlusive event outcomes that may be attributable to high-dose imatinib and prior standard-dose imatinib exposure.

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