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Blast Count Prognostic for CML Presenting in Advanced Phase

Mortality risk significantly higher for patients with 20 to 29 percent versus less than 20 percent blasts

THURSDAY, Sept. 26, 2019 (HealthDay News) — Blast count seems to be the main prognostic count for patients with chronic myeloid leukemia (CML) presenting in an advanced phase, according to a study published online Aug. 27 in the American Journal of Hematology.

Michael Lauseker, Ph.D., from Ludwig-Maximilians-Universität München in Germany, and colleagues examined prognostic factors for a cohort of 283 patients diagnosed in the advanced phase of CML. Nearly all of the patients received tyrosine kinase inhibitor treatment.

The researchers found that median survival was 8.2 years in the heterogeneous cohort. The hazard ratio for mortality was 1.32 (95 percent confidence interval [CI], 0.7 to 2.6) when comparing patients with >30 percent versus 20 to 29 percent blasts, respectively. Significantly higher risk for mortality was seen for patients with 20 to 29 percent versus <20 percent blasts (hazard ratio, 2.24; 95 percent CI, 1.2 to 4.0). The most important prognostic factor was blast count; however, age, hemoglobin, basophils, and other chromosomal aberrations should also be considered. Two groups were defined by the Eutos long-term survival score: high and non-high risk, with a hazard ratio of 3.01 (95 percent CI, 1.81 to 5.00).

“It is our perception that a two-phase rather than a three-phase categorization of de novo patients is appropriate,” the authors write. “And, that a 20 percent blast cut-off could be involved in a new definition, only discriminating between chronic phase and blast crisis at diagnosis.”

Several authors disclosed ties to the pharmaceutical industry.

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