{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:35:10Z","timestamp":1791815710591,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tyrosine kinase inhibitors (TKIs) have profoundly improved the clinical outcome for patients with chronic myeloid leukemia (CML), but their overall survival is still subnormal and the treatment is associated with adverse events. In a large cohort\u2010study, we assessed the morbidity in 1328 Swedish CML chronic phase patients diagnosed 2002\u20132017 and treated with TKIs, as compared to that in carefully matched control individuals. Several Swedish patient registers with near\u2010complete nationwide coverage were utilized for data acquisition. Median follow\u2010up was 6 (IQR, 3\u201310) years with a total follow\u2010up of 8510 person\u2010years for the full cohort. Among 670 analyzed disease categories, the patient cohort showed a significantly increased risk in 142 while, strikingly, no category was more common in controls. Increased incidence rate ratios\/IRR (95% CI) for more severe events among patients included acute myocardial infarction (AMI) 2.0 (1.5\u20132.6), heart failure 2.6 (2.2\u20133.2), pneumonia 2.8 (2.3\u20133.5), and unspecified sepsis 3.5 (2.6\u20134.7). When comparing patients on 2nd generation TKIs vs. imatinib in a within\u2010cohort analysis, nilotinib generated elevated IRRs for AMI (2.9; 1.5\u20135.6) and chronic ischemic heart disease (2.2; 1.2\u20133.9), dasatinib for pleural effusion (11.6; 7.6\u201317.7) and infectious complications, for example, acute upper respiratory infections (3.0; 1.4\u20136.0). Our extensive real\u2010world data reveal significant risk increases of severe morbidity in TKI\u2010treated CML patients, as compared to matched controls, particularly for 2nd generation TKIs. Whether this increased morbidity may also translate into increased mortality, thus preventing CML patients to achieve a normalized overall survival, needs to be further explored.<\/jats:p>","DOI":"10.1002\/ajh.26463","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T10:37:00Z","timestamp":1641897420000},"page":"421-430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Adverse outcomes in chronic myeloid leukemia patients treated with tyrosine kinase inhibitors: Follow\u2010up of patients diagnosed 2002\u20132017 in a complete coverage and nationwide agnostic register study"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3856-7227","authenticated-orcid":false,"given":"Torsten","family":"Dahl\u00e9n","sequence":"first","affiliation":[{"name":"Department of Medicine Solna, Clinical Epidemiology Division Karolinska Institutet  Stockholm 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