Development of a prognostic scoring system for chronic myeloid leukemia in blast phase

Currently there is no established prognostic scoring system for patients with chronic myeloid leukemia (CML) in blast phase (BP). This study aimed to identify prognostic factors of CML-BP in a large cohort of prospectively and retrospectively collected patients and to develop a readily available prognostic scoring system at the onset of BP to enable future comparison between different trials and series. The analyses were based on 275 patients from thirteen countries, collected within the European LeukemiaNet Blast Phase Registry with a median observation time of 45 months and a median OS of 18.9 months. A Cox proportional hazards model for overall survival (OS) was employed, missing values were imputed. The study identified six independent prognostic factors: blast percentage, platelet count, age (all at onset of CML-BP), immunophenotype of BP, extramedullary disease, and previous history of CML. The low-risk group, encompassing 14% of patients, had a median OS of 97 months, the intermediate-risk group (59% of patients) of 22 months, and the high-risk group (27% of patients) of 9 months. Cross-validation demonstrated a good performance of the score, although external validation is strongly recommended. Despite the inherent limitations of registry data, the findings offer robust insights into prognostic factors for CML-BP.

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Journal
Leukemia
Published
2026-02-19
DOI
https://doi.org/10.1038/s41375-026-02875-9
Primary Topic
Chronic Myeloid Leukemia Treatments
Type
article
Field-Weighted Citation Impact
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article

Development of a prognostic scoring system for chronic myeloid leukemia in blast phase

I Zupan, S. Saussele, Elżbieta Szczepanek, S. Krause et al.
Leukemia
Chronic Myeloid Leukemia Treatments
article

Development of a prognostic scoring system for chronic myeloid leukemia in blast phase

I Zupan, S. Saussele, Elżbieta Szczepanek, S. Krause, J. Apperley, Holger Hebart, Luis Felipe Casado, Annamaria Brioli, Fausto Castagnetti, Klaus Hirschbühl, Philipp Ernst, Peter Anhut, Aleksandra Gołoś, Daniela Žáčková, Edyta Paczkowska, Elza Lomaia, Jochen J. Frietsch, Christian Fabisch, T Südhoff, Astghik Voskanyan, Justyna Gil, Anne Parry, Markus Pfirrmann, Georg-Nikolaus Franke, Elżbieta Patkowska, Ulla Olsson-Strömberg, Michael Lauseker, Alexander Kiani, Franck E. Nicolini, Krzysztof Lewandowski, Andreas Hochhaus, Julia Yakoleva, Hana Klamova, Jiri Mayer, Tomasz Sacha, Edgar Faber, Sonja Heibl, Dragana Milojkovic, Thomas Ernst, Matthias Eder
article en

Abstract

Currently there is no established prognostic scoring system for patients with chronic myeloid leukemia (CML) in blast phase (BP). This study aimed to identify prognostic factors of CML-BP in a large cohort of prospectively and retrospectively collected patients and to develop a readily available prognostic scoring system at the onset of BP to enable future comparison between different trials and series. The analyses were based on 275 patients from thirteen countries, collected within the European LeukemiaNet Blast Phase Registry with a median observation time of 45 months and a median OS of 18.9 months. A Cox proportional hazards model for overall survival (OS) was employed, missing values were imputed. The study identified six independent prognostic factors: blast percentage, platelet count, age (all at onset of CML-BP), immunophenotype of BP, extramedullary disease, and previous history of CML. The low-risk group, encompassing 14% of patients, had a median OS of 97 months, the intermediate-risk group (59% of patients) of 22 months, and the high-risk group (27% of patients) of 9 months. Cross-validation demonstrated a good performance of the score, although external validation is strongly recommended. Despite the inherent limitations of registry data, the findings offer robust insights into prognostic factors for CML-BP.

Leukemia
Poznan University of Medical Sciences (PL), Jagiellonian University (PL), Uppsala University Hospital (SE), Imperial College Healthcare NHS Trust (GB), University of Ljubljana (SI), Inserm (FR), Zimmer Biomet (Netherlands) (NL), University of Augsburg (DE), Masaryk University (CZ), Heidelberg University (DE), Universitätsmedizin Greifswald (DE), First Pavlov State Medical University of St. Petersburg (RU), Ljubljana University Medical Centre (SI), Hammersmith Hospital (GB), Bayreuth Medical Center (DE), Federal Almazov North-West Medical Research Centre (RU), Medizinische Hochschule Hannover (DE), Institut für Medizinische Informatik, Biometrie und Epidemiologie (DE), Universitätsklinikum Erlangen (DE), Instytut Hematologii i Transfuzjologi (PL), Centre de Recherche en Neurosciences de Lyon (FR), Institute of Haematology and Blood Transfusion (CZ), University Hospital Brno (CZ), Centre Léon Bérard (FR), University Hospital Olomouc (CZ), Copernicus Memorial Hospital (PL), Istituto di Ematologia di Bologna (IT), Klinikum Wels-Grieskirchen (AT), Centre de Recherche en Cancérologie de Lyon (FR), Lublin Oncology Center (PL), University Hospital Leipzig (DE), Centre Hospitalier Annecy Genevois (FR), Jena University Hospital (DE), Praxis für Hämatologie und Onkologie (DE), Klinik und Poliklinik für Neurologie (DE), Comprehensive Cancer Center Erlangen (DE), Klinikum Passau (DE), University Hospital Carl Gustav Carus (DE), Complejo Hospitalario Universitario de Toledo (ES), Klinik und Poliklinik für Psychotherapie und Psychosomatik (DE), Palacký University Olomouc (CZ), Pomeranian Medical University (PL), Ludwig-Maximilians-Universität München (DE), Leipzig University (DE), University of Bologna (IT)
Universitätsklinikum Jena
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Chronic Myeloid Leukemia Treatments
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