{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:04:59Z","timestamp":1784178299233,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>The prognostic significance of myelodysplasia-related gene mutations (MDS-RGMs), defined by the ELN 2022 classification and Mutation-Enhanced International Prognostic Score System high-risk mutations (MIPSS70-HRM), in accelerated-phase (AP) and blast-phase (BP) myeloproliferative neoplasms (MPNs) remains unclear. We conducted a retrospective study of 101 AP\/BP MPN patients with intermediate-risk cytogenetics, excluding TP53 mutations and adverse-risk karyotypes. We evaluated whether MDS-RGM or MIPSS70-HRM predicted treatment response, overall survival (OS), or disease-free survival (DFS) and whether treatment intensity affected OS. Patients included AP (29.7%) and BP (70.3%), with 55% receiving intensive therapy. Allogeneic stem cell transplant (ASCT) significantly improved OS (HR 0.31, 95% CI 0.19\u20130.50; p &lt; 0.0001), as did AP versus BP at transformation (HR: 0.43, 95% CI 0.26\u20130.73; p = 0.0016). Among patients \u2264 70 years with ECOG 0\u20131 (N = 77), ASCT and reversion to chronic-phase MPN (cMPN) were associated with longer OS (p &lt; 0.0001 and p = 0.0475). Treatment intensity alone did not significantly affect OS (p = 0.1991).<\/jats:p>","DOI":"10.3390\/curroncol33070419","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:05:31Z","timestamp":1783929931000},"page":"419","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of High-Risk Mutations and Treatment Intensity in Accelerated-Phase Blast-Phase MPN Without Adverse-Risk Karyotype and TP53"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4921-8102","authenticated-orcid":false,"given":"Verna","family":"Cheung","sequence":"first","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"},{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Davidson","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-3680","authenticated-orcid":false,"given":"Eshetu G.","family":"Atenafu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University Health Network, Toronto, ON M5G 1X6, Canada"},{"name":"Division of Biostatistics, DLSPH, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Arruda","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime O.","family":"Claudio","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniket","family":"Bankar","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Maze","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Gupta","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9030-8583","authenticated-orcid":false,"given":"Hassan","family":"Sibai","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2658","DOI":"10.1182\/bloodadvances.2018021469","article-title":"The mutational landscape of accelerated- and blast-phase myeloproliferative neoplasms impacts patient outcomes","volume":"2","author":"McNamara","year":"2018","journal-title":"Blood Adv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1182\/bloodadvances.2023011735","article-title":"Outcomes of intensive and nonintensive blast-reduction strategies in accelerated and blast-phase MPN","volume":"8","author":"Davidson","year":"2024","journal-title":"Blood Adv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1111\/bjh.20187","article-title":"Heterogeneity in outcomes of TP53-mutated myeloproliferative neoplasms based on disease phenotype and mutational status","volume":"207","author":"Badar","year":"2025","journal-title":"Br. J. Haematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/ajh.27609","article-title":"TP53 Mutations in Myeloproliferative Neoplasms: Context-Dependent Evaluation of Prognostic Relevance","volume":"100","author":"Tefferi","year":"2025","journal-title":"Am. J. Hematol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1182\/blood.2022016867","article-title":"Diagnosis and management of AML in adults: 2022 Recommendations from an international expert panel on behalf of the ELN","volume":"140","author":"Wei","year":"2022","journal-title":"Blood"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1200\/JCO.2017.76.4886","article-title":"MIPSS70: Mutation-Enhanced International Prognostic Score System for Transplantation-Age Patients with Primary Myelofibrosis","volume":"36","author":"Guglielmelli","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101379","DOI":"10.1016\/j.beha.2022.101379","article-title":"Accelerated and blast phase myeloproliferative neoplasms","volume":"35","author":"Saliba","year":"2022","journal-title":"Best Pract. Res. Clin. Haematol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1038\/s41408-023-00878-8","article-title":"Blast phase myeloproliferative neoplasm: Contemporary review and 2024 treatment algorithm","volume":"13","author":"Tefferi","year":"2023","journal-title":"Blood Cancer J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1002\/ajh.26833","article-title":"Outcomes after allogeneic hematopoietic cell transplant in patients diagnosed with blast phase of myeloproliferative neoplasms: A retrospective study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation","volume":"98","author":"Gras","year":"2023","journal-title":"Am. J. Hematol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4748","DOI":"10.1182\/bloodadvances.2020002621","article-title":"Comparison of outcomes of HCT in blast phase of BCR-ABL1-MPN with de novo AML and with AML following MDS","volume":"4","author":"Gupta","year":"2020","journal-title":"Blood Adv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1111\/bjh.17423","article-title":"Allogeneic stem cell transplant for patients with myeloproliferative neoplasms in blast phase: Improving outcomes in the recent era","volume":"193","author":"Shah","year":"2021","journal-title":"Br. J. Haematol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/bjh.15819","article-title":"Impact of primary disease on outcome after allogeneic stem cell transplantation for transformed secondary acute leukaemia","volume":"185","author":"Eikema","year":"2019","journal-title":"Br. J. Haematol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1182\/bloodadvances.2021006827","article-title":"Reduced intensity hematopoietic stem cell transplantation for accelerated-phase myelofibrosis. Reduced intensity hematopoietic stem cell transplantation for accelerated-phase myelofibrosis","volume":"6","author":"Gagelmann","year":"2022","journal-title":"Blood Adv."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.3324\/haematol.2022.282019","article-title":"Predictors of response to venetoclax plus hypomethylating agent therapy and survival in blast phase myeloproliferative neoplasm","volume":"108","author":"Gangat","year":"2023","journal-title":"Haematologica"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.leukres.2010.05.008","article-title":"Therapeutic options for patients with myelofibrosis in blast phase","volume":"34","author":"Mascarenhas","year":"2010","journal-title":"Leuk. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3468","DOI":"10.1182\/bloodadvances.2024012880","article-title":"Treatment approach and outcomes of patients with accelerated\/blast-phase myeloproliferative neoplasms in the current era","volume":"8","author":"Patel","year":"2024","journal-title":"Blood Adv."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1182\/blood-2024-203706","article-title":"Phase 1b\/2 Study of Magrolimab (Magro), Azacitidine (AZA) and Venetoclax (VEN) in Patients (pts) with Newly Diagnosed (ND) Older\/Unfit or High Risk Acute Myeloid Leukemia (AML) and Relapsed Refractory (R\/R) AML: Final Clinical Data and Genomic Markers of Resistance\/Relapse","volume":"144","author":"Arora","year":"2024","journal-title":"Blood"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1182\/blood.2021013404","article-title":"Oral azacitidine prolongs survival of patients with AML in remission independently of measurable residual disease status","volume":"139","author":"Roboz","year":"2022","journal-title":"Blood"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1002\/ajh.27564","article-title":"Mayo Genetic Risk Models for Newly Diagnosed Acute Myeloid Leukemia Treated with Venetoclax \u2009+ \u2009Hypomethylating Agent","volume":"100","author":"Gangat","year":"2025","journal-title":"Am. J. Hematol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Shaw, R., Yoon, J.J., Johnston, H., Davidson, M.B., Siddon, A.J., Shallis, R.M., Chen, E.C., Burkart, M., Oh, T.S., and Iyer, S.G. (2025). Assessing AML-based risk criteria in patients with accelerated\/blast-phase MPN treated with less-intensive therapy. Blood Adv., epub ahead of print.","DOI":"10.1182\/bloodadvances.2024015712"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/7\/419\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:32:16Z","timestamp":1784176336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/7\/419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,12]]},"references-count":20,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["curroncol33070419"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33070419","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,12]]}}}