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However, it is yet unclear whether TKI selection, particularly, imatinib versus second\u2010generation TKIs (2GTKIs), impacts treatment outcomes in the clinical practice. To address this, we compared the clinical outcomes of prospectively registered 452 patients with CML\u2010CP treated with imatinib and 2GTKIs, taking into consideration their age and\/or comorbidities. A total of 136 patients (30.1%) were classified into an older cohort (\u226565\u2009years) and 316 (69.9%) into a younger cohort (18\u201064\u2009years). The TKI selection did not vary based on age (70.6% received 2GTKIs in the younger cohort and 66.2% in the older cohort). The median follow\u2010up period was 5.4\u2009years. Treatment responses including the cumulative incidence of deep molecular response (BCR\u2010ABL1 international scale \u22640.0032%) at any time were similar between the two age cohorts regardless of the type of TKI. The 5\u2010year overall survival (OS) in the older cohort was lower than that in the younger cohort (95.9% vs 83.8%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), whereas the 5\u2010year OS in patients treated with 2GTKIs was not influenced by age factors and comorbidities. Therefore, our results suggest that the selection of 2GTKIs as first\u2010line treatment is an effective option for both younger and older CML\u2010CP patients with or without comorbidities. This trial was registered at UMIN\u2010CTR as 00003581.<\/jats:p>","DOI":"10.1111\/cas.15642","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T07:38:47Z","timestamp":1667806727000},"page":"995-1006","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical outcomes of second\u2010generation tyrosine kinase inhibitors versus imatinib in older patients with <scp>CML<\/scp>"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3922-7432","authenticated-orcid":false,"given":"Takaaki","family":"Ono","sequence":"first","affiliation":[{"name":"Department of Transfusion and Cell Therapy Hamamatsu University School of Medicine  Hamamatsu Shizuoka 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