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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.
Lauseker, Michael; Bachl, Katharina; Turkina, Anna; Faber, Edgar; Prejzner, Witold; Olsson-Strömberg, Ulla; Baccarani, Michele; Lomaia, Elza; Zackova, Daniela; Ossenkoppele, Gert; Griskevicius, Laimonas; Schubert-Fritschle, Gabriele; Sacha, Tomasz; Heibl, Sonja; Koskenvesa, Perttu; Bogdanovic, Andrija; Clark, Richard E; Guilhot, Joelle; Hoffmann, Verena S; Hasford, Joerg; Hochhaus, Andreas; Pfirrmann, Markus.
Afiliação
  • Lauseker M; Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
  • Bachl K; Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
  • Turkina A; National Research Center for Hematology, Moscow, Russia.
  • Faber E; Department of Hematology-Oncology, University Hospital, Palacky University, Olomouc, Czech Republic.
  • Prejzner W; Department of Hematology, Medical University of Gdansk, Gdansk, Poland.
  • Olsson-Strömberg U; Department of Internal Medicine, Department of Medical Science and Division of Hematology, University Hospital, Uppsala, Sweden.
  • Baccarani M; Department of Hematology and Oncology L. and A, University of Bologna, Bologna, Italy.
  • Lomaia E; Clinical oncology - Research department of oncology and hematology, Almazov Medical Research Center, St Petersburg, Russian Federation.
  • Zackova D; Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, Brno, Czech Republic.
  • Ossenkoppele G; Department of Hematology, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands.
  • Griskevicius L; Vilnius University Hospital Santaros Klinikos and Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.
  • Schubert-Fritschle G; Munich Cancer Registry, Ludwig-Maximilians-Universität München, Munich, Germany.
  • Sacha T; Chair and Department of Hematology, Jagiellonian University Hospital, Kraków, Poland.
  • Heibl S; Department for Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria.
  • Koskenvesa P; Helsinki University Hospital Cancer Center and Hematology Research Unit, Helsinki University, Helsinki, Finland.
  • Bogdanovic A; Clinic of Hematology CCS and Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
  • Clark RE; Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
  • Guilhot J; Clinical Investigation Center, INSERM CIC 1402, CHU Poitiers, Poitiers, France.
  • Hoffmann VS; Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
  • Hasford J; Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
  • Hochhaus A; Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany.
  • Pfirrmann M; Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
Am J Hematol ; 94(11): 1236-1243, 2019 11.
Article em En | MEDLINE | ID: mdl-31456269
ABSTRACT
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.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Leucemia Mieloide de Fase Acelerada / Crise Blástica Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Leucemia Mieloide de Fase Acelerada / Crise Blástica Idioma: En Ano de publicação: 2019 Tipo de documento: Article