Prognosis of patients with chronic myeloid leukemia presenting in advanced phase is defined mainly by blast count, but also by age, chromosomal aberrations and hemoglobin.
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Blast Crisis
/ blood
Bone Marrow
/ pathology
Cell Count
Chromosome Aberrations
Europe
/ epidemiology
Female
Follow-Up Studies
Hemoglobins
/ analysis
Humans
Kaplan-Meier Estimate
Leukemia, Myeloid, Accelerated Phase
/ blood
Male
Middle Aged
Neoplasm Staging
/ methods
Neoplastic Stem Cells
Prognosis
Proportional Hazards Models
Registries
Young Adult
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
12
07
2019
revised:
19
08
2019
accepted:
22
08
2019
pubmed:
29
8
2019
medline:
27
3
2020
entrez:
29
8
2019
Statut:
ppublish
Résumé
Chronic myeloid leukemia (CML) is usually diagnosed in chronic phase, yet there is a small percentage of patients that is diagnosed in accelerated phase or blast crisis. Due to this rarity, little is known about the prognosis of these patients. Our aim was to identify prognostic factors for this cohort. We identified 283 patients in the EUTOS population-based and out-study registries that were diagnosed in advanced phase. Nearly all patients were treated with tyrosine kinase inhibitors. Median survival in this heterogeneous cohort was 8.2 years. When comparing patients with more than 30% blasts to those with 20-29% blasts, the hazard ratio (HR) was 1.32 (95%-confidence interval (CI): [0.7-2.6]). Patients with 20-29% blasts had a significantly higher risk than patients with less than 20% blasts (HR: 2.24, 95%-CI: [1.2-4.0], P = .008). We found that the blast count was the most important prognostic factor; however, age, hemoglobin, basophils and other chromosomal aberrations should be considered as well. The ELTS score was able to define two groups (high risk vs non-high risk) with an HR of 3.01 (95%-CI: [1.81-5.00], P < .001). Regarding the contrasting definitions of blast crisis, our data clearly supported the 20% cut-off over the 30% cut-off in this cohort. Based on our results, we conclude that a one-phase rather than a two-phase categorization of de novo advanced phase CML patients is appropriate.
Substances chimiques
Hemoglobins
0
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1236-1243Informations de copyright
© 2019 The Authors. American Journal of Hematology published by Wiley Periodicals, Inc.
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