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

J 2019

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, Katharina BACHL, Anna TURKINA, Edgar FABER, Witold PREJZNER et. al.

Basic information

Original name

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

Authors

LAUSEKER, Michael (276 Germany, guarantor), Katharina BACHL (276 Germany), Anna TURKINA (643 Russian Federation), Edgar FABER (203 Czech Republic), Witold PREJZNER (616 Poland), Ulla OLSSON-STROMBERG, (752 Sweden), Michele BACCARANI (380 Italy), Elza LOMAIA (643 Russian Federation), Daniela ŽÁČKOVÁ (203 Czech Republic, belonging to the institution), Gert OSSENKOPPELE (528 Netherlands), Laimonas GRISKEVICIUS (440 Lithuania), Gabriele SCHUBERT-FRITSCHLE (276 Germany), Tomasz SACHA (616 Poland), Sonja HEIBL (40 Austria), Perttu KOSKENVESA (246 Finland), Andrija BOGDANOVIC (688 Serbia), Richard E. CLARK (826 United Kingdom of Great Britain and Northern Ireland), Joelle GUILHOT (250 France), Verena S. HOFFMANN (276 Germany), Joerg HASFORD (276 Germany), Andreas HOCHHAUS (276 Germany) and Markus PFIRRMANN (276 Germany)

Edition

American Journal of Hematology, Hoboken, John Wiley & Sons, 2019, 0361-8609

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30205 Hematology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 6.973

RIV identification code

RIV/00216224:14110/19:00112499

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1002/ajh.25628

UT WoS

000490182700018

Keywords in English

WORLD-HEALTH-ORGANIZATION; CHRONIC MYELOGENOUS LEUKEMIA; TYROSINE KINASE INHIBITORS; 2904 CML PATIENTS; RANDOMIZED CML; SURVIVAL; MANAGEMENT; IMATINIB; ERA; RECOMMENDATIONS

Abstract

V originále

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.

Citovat

LAUSEKER, Michael, Katharina BACHL, Anna TURKINA, Edgar FABER, Witold PREJZNER, Ulla OLSSON-STROMBERG,, Michele BACCARANI, Elza LOMAIA, Daniela ŽÁČKOVÁ, Gert OSSENKOPPELE, Laimonas GRISKEVICIUS, Gabriele SCHUBERT-FRITSCHLE, Tomasz SACHA, Sonja HEIBL, Perttu KOSKENVESA, Andrija BOGDANOVIC, Richard E. CLARK, Joelle GUILHOT, Verena S. HOFFMANN, Joerg HASFORD, Andreas HOCHHAUS and Markus PFIRRMANN. 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. American Journal of Hematology. Hoboken: John Wiley & Sons, 2019, vol. 94, No 11, p. 1236-1243. ISSN 0361-8609. Available from: https://dx.doi.org/10.1002/ajh.25628.

@article{1605421,
   author = {Lauseker, Michael and Bachl, Katharina and Turkina, Anna and Faber, Edgar and Prejzner, Witold and OlssonandStromberg,, Ulla and Baccarani, Michele and Lomaia, Elza and Žáčková, Daniela and Ossenkoppele, Gert and Griskevicius, Laimonas and SchubertandFritschle, Gabriele and Sacha, Tomasz and Heibl, Sonja and Koskenvesa, Perttu and Bogdanovic, Andrija and Clark, Richard E. and Guilhot, Joelle and Hoffmann, Verena S. and Hasford, Joerg and Hochhaus, Andreas and Pfirrmann, Markus},
   article_location = {Hoboken},
   article_number = {11},
   doi = {http://dx.doi.org/10.1002/ajh.25628},
   keywords = {WORLD-HEALTH-ORGANIZATION; CHRONIC MYELOGENOUS LEUKEMIA; TYROSINE KINASE INHIBITORS; 2904 CML PATIENTS; RANDOMIZED CML; SURVIVAL; MANAGEMENT; IMATINIB; ERA; RECOMMENDATIONS},
   language = {eng},
   issn = {0361-8609},
   journal = {American Journal of Hematology},
   title = {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},
   url = {http://dx.doi.org/10.1002/ajh.25628},
   volume = {94},
   year = {2019}
}

TY  - JOUR
ID  - 1605421
AU  - Lauseker, Michael - Bachl, Katharina - Turkina, Anna - Faber, Edgar - Prejzner, Witold - Olsson-Stromberg,, Ulla - Baccarani, Michele - Lomaia, Elza - Žáčková, 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
PY  - 2019
TI  - 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
JF  - American Journal of Hematology
VL  - 94
IS  - 11
SP  - 1236-1243
EP  - 1236-1243
PB  - John Wiley & Sons
SN  - 03618609
KW  - WORLD-HEALTH-ORGANIZATION
KW  - CHRONIC MYELOGENOUS LEUKEMIA
KW  - TYROSINE KINASE INHIBITORS
KW  - 2904 CML PATIENTS
KW  - RANDOMIZED CML
KW  - SURVIVAL
KW  - MANAGEMENT
KW  - IMATINIB
KW  - ERA
KW  - RECOMMENDATIONS
UR  - http://dx.doi.org/10.1002/ajh.25628
L2  - http://dx.doi.org/10.1002/ajh.25628
N2  - 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.
ER  -

LAUSEKER, Michael, Katharina BACHL, Anna TURKINA, Edgar FABER, Witold PREJZNER, Ulla OLSSON-STROMBERG,, Michele BACCARANI, Elza LOMAIA, Daniela ŽÁČKOVÁ, Gert OSSENKOPPELE, Laimonas GRISKEVICIUS, Gabriele SCHUBERT-FRITSCHLE, Tomasz SACHA, Sonja HEIBL, Perttu KOSKENVESA, Andrija BOGDANOVIC, Richard E. CLARK, Joelle GUILHOT, Verena S. HOFFMANN, Joerg HASFORD, Andreas HOCHHAUS and Markus PFIRRMANN. 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. \textit{American Journal of Hematology}. Hoboken: John Wiley \&{} Sons, 2019, vol.~94, No~11, p.~1236-1243. ISSN~0361-8609. Available from: https://dx.doi.org/10.1002/ajh.25628.

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