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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.<\/jats:p>","DOI":"10.1038\/s41375-026-02875-9","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T09:13:39Z","timestamp":1771492419000},"page":"751-758","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development of a prognostic scoring system for chronic myeloid leukemia in blast 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DZ has served as a member of advisory boards for Novartis, Zentiva, Ascentage, and Enliven; has served on speakers\u2019 bureaus for Novartis and Angelini; has acted as a consultant for Novartis and Angelini; and has received travel grants from Novartis and Angelini. KL has participated in advisory boards and received honoraria from Novartis, Bristol-Myers Squibb, Pfizer, Angelini Pharma, GSK and AOP Orphan. PE has participated in advisory boards for Novartis and Pfizer, and has received research funding from Novartis. KH has participated in advisory boards from Pfizer, Novartis, Incyte, GSK, SERB and received honoraria and travel support from Jazz, Novartis, Gilead, Roche, Pfizer, Amgen, Astellas, Merck, and AbbVie. JF received honoraria from Novartis, Stemline, AbbVie, Medac, Therakos, JAZZ, Takeda and Janssen-Cilag. EF received honoraria from Angelini and Novartis and received study and travel support from Novartis. SH has participated in advisory boards and received honoraria and travel support from Novartis, BMS, Pfizer, Sanofi, AstraZeneca, Johnson & Johnson, GSK, Amgen, Gilead, and Roche. KTG has participated in advisory boards from Argenx, Amgen, Sanofi, Sobi and received honoraria and travel support from Grifols, Novartis, NovoNordisk, SOBI. JM received research support from Novartis. AK received research support from Novartis and participated in advisory boards and received honoraria from Novartis, Bristol Myers Squibb, and Pfizer. JFA has participated in advisory boards for Ascentage, Incyte, Novartis and Terns, has received honoraria from Incyte, Novartis and Paladin, and research support from Incyte and Pfizer. AB has participated in advisory boards from BMS, Janssen, GSK, Pfizer, AstraZeneca and Sanofi and received honoraria and travel support from BMS, Janssen, GSK, Sanofi, Amgen and AstraZeneca. All other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}