{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:01:05Z","timestamp":1790402465030,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T00:00:00Z","timestamp":1500940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"MD Anderson Cancer Center Support Grant","award":["CA049639"],"award-info":[{"award-number":["CA049639"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,11,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Outcomes in patients with chronic myeloid leukemia in blast phase (CML\u2010BP) are historically dismal. Herein, the authors sought to analyze the characteristics, prognostic factors, and survival outcomes in patients with CML\u2010BP in the tyrosine kinase inhibitor (TKI) era.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A total of 477 patients with CML\u2010BP were treated with a TKI at some point during the course of their CML. Cox proportional hazard models identified characteristics that were predictive of survival. Overall survival and failure\u2010free survival were assessed. Optimal cutoff points for specific parameters were identified using classification and regression tree (CART) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The median age of the patients was 53 years (range, 16\u201084 years) and 64% were male. Approximately 80% of patients initially were diagnosed in the chronic phase of CML at a median of 41 months (range, 0.7\u2010298 months) before transformation to CML\u2010BP. De novo CML\u2010BP occurred in 71 patients. Approximately 72% of patients received TKI therapy before CML\u2010BP. The initial therapy for CML\u2010BP included a TKI alone (35%), a TKI with chemotherapy (46%), and non\u2010TKI therapies (19%). The median overall survival was 12 months and the median failure\u2010free survival was 5 months. In multivariate analysis, myeloid immunophenotype, prior TKI, age \u226558 years, lactate dehydrogenase level \u22651227 IU\/L, platelet count\u2009&lt;\u2009102 K\/\u03bcL, no history of stem cell transplantation, transition to BP from chronic phase\/accelerated phase, and the presence of chromosome 15 aberrations predicted for a significantly increased risk of death. Achievement of major hematologic response and\/or complete cytogenetic response to first\u2010line treatment was found to be predictive of better survival. The combination of a TKI with intensive chemotherapy followed by stem cell transplantation appeared to confer the best outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients with CML\u2010BP continue to pose a therapeutic challenge, have dismal outcomes, and require newer treatment approaches. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:4391\u2010402<\/jats:bold>. \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30864","type":"journal-article","created":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T17:42:43Z","timestamp":1501004563000},"page":"4391-4402","source":"Crossref","is-referenced-by-count":153,"title":["Prognostic factors and survival outcomes in patients with chronic myeloid leukemia in blast phase in the tyrosine kinase inhibitor era: Cohort study of 477 patients"],"prefix":"10.1002","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-168X","authenticated-orcid":false,"given":"Preetesh","family":"Jain","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagop M.","family":"Kantarjian","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Ghorab","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9140-0610","authenticated-orcid":false,"given":"Koji","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias J.","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela","family":"Nogueras Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7829-5249","authenticated-orcid":false,"given":"Rashmi","family":"Kanagal\u2010Shamanna","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghayas 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Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7103-373X","authenticated-orcid":false,"given":"Naval G.","family":"Daver","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9892-9832","authenticated-orcid":false,"given":"Tapan M.","family":"Kadia","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Borthakur","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston 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