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.
Yun S, Vincelette ND, Abraham I. Multiple Causes of Cardiotoxic Effects in Patients With Chronic Myeloid Leukemia. JAMA Oncol. 2016;2(6):828-829. doi:10.1001/jamaoncol.2016.1005