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To the Editor
Leong and colleagues1 performed an important retrospective cohort study to assess the risk of MACE between patients with and without chronic myeloid leukaemia (CML), with subgroup analysis by patients present before and after the market introduction of tyrosine kinase inhibitors (TKIs) (cut-off at 2001).
However, the cohort design has several limitations. While the cut-point by TKI marketing at first seems logical, TKIs as a group have drastically changed since the early 2000s. For example, TKI access was often restricted among older adults because initial studies showed the greatest survival benefit in younger patients.2 Also, many patients who were diagnosed prior to 2001 were eventually treated with TKIs.
Furthermore, later-generation TKIs …
Contributors Both ML and MG were contributors to this paper in that they provided substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data; drafting the work or revising it critically for important intellectual content; final approval of the version published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Commissioned; internally peer reviewed.
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