BLAST demonstrates higher prognostic accuracy for survival than CPSS in Chinese patients with chronic myelomonocytic leukemia

Chronic myelomonocytic leukemia (CMML) is a hematopoietic stem cell-derived myeloid malignancy that exhibits marked biological and clinical heterogeneity, with substantial variability in patient prognosis [ 1 , 2 , 3 ]. Early identification of high-risk patients who may benefit from timely allogeneic hematopoietic stem cell transplantation (allo-HSCT) is therefore critical. Over the past two decades, several prognostic models have been developed for CMML, ranging from systems based solely on clinical parameters to those incorporating cytogenetic and molecular features [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Among these, clinical tools such as CMML-specific Prognostic Scoring System (CPSS) and CPSS-Molecular (CPSS-mol) are the most widely used. Recently, Tefferi et al. [ 14 ] developed the Blasts, Leukocytes, and Anemia-based Survival Tool for Chronic Myelomonocytic Leukemia (BLAST), a prognostic model based exclusively on easily accessible clinical variables, as well as an updated version integrating molecular data, the Blasts, Leukocytes, and Anemia-based Survival Tool with Molecular Integration for Chronic Myelomonocytic Leukemia (BLAST-mol), and showed that they outperform existing tools. However, the BLAST and BLAST-mol have been validated only in Western patient cohorts, and their performance in Chinese patients remains unclear. Therefore, this study aims to compare the prognostic predictive performance of the BLAST, BLAST-mol, CPSS, and CPSS-mol in Chinese CMML patients.