A NEW prognostic scoring system for chronic myeloid leukaemia blast phase may improve survival prediction and risk stratification, based on analysis of a large international patient cohort.
Prognostic Score in CML Blast Phase
There is currently no established prognostic scoring system for patients in blast phase of chronic myeloid leukaemia, a stage associated with poor outcomes and significant clinical heterogeneity. To address this gap, investigators analysed data from 275 patients across 13 countries enrolled in the European LeukemiaNet Blast Phase Registry. The cohort included both prospectively and retrospectively collected cases, with a median observation time of 45 months and a median overall survival of 18.9 months.
Using a Cox proportional hazards model, with missing data imputed, the study aimed to identify independent prognostic factors present at the onset of blast phase and to develop a clinically applicable scoring system.
Key Risk Factors Identified
Six independent prognostic factors were identified as significantly associated with overall survival. These included blast percentage, platelet count, and age at onset of blast phase, alongside immunophenotype, presence of extramedullary disease, and previous history of chronic myeloid leukaemia.
These variables were integrated into a scoring system that stratified patients into three distinct risk groups. The low-risk group, representing 14% of patients, demonstrated a median overall survival of 97 months. The intermediate risk group, comprising 59% of patients, had a median overall survival of 22 months. The high-risk group, accounting for 27% of patients, showed a markedly reduced median overall survival of 9 months.
Clinical Implications and Validation
Cross validation indicated good performance of the prognostic score, supporting its potential utility in clinical and research settings. The authors suggest that this tool could facilitate comparisons across clinical trials and observational series, particularly with regard to treatment outcomes in blast phase disease.
However, the findings should be interpreted in the context of registry-based data, which may carry inherent limitations. External validation is strongly recommended to confirm the generalisability and robustness of the scoring system.
Overall, this study provides important insights into prognostic determinants in blast phase chronic myeloid leukaemia and introduces a practical framework for risk stratification at disease onset.
Reference
Lauseker M et al. Development of a prognostic scoring system for chronic myeloid leukemia in blast phase. Leukaemia. 2026; https://doi.org/10.1038/s41375-026-02875-9.
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