Combining a tyrosine kinase inhibitor (TKI) with intensive chemotherapy after stem cell transplantation seems to work the best in patients with chronic myeloid leukemia in blast phase (CML-BP), according to a cohort study involving 477 individuals. Participants with CML-BP were treated with a TKI at some point during their illness. Investigators looked at overall and failure-free survival. Among the results:
- 7 in every 10 patients received TKI therapy before CML-BP.
- Median overall and failure-free survival were 12 and 5 months, respectively.
- A TKI/chemo combination conferred the best response.
- Patients ≥58 years of age and those who had previously taken a TKI had significantly increased risk of mortality.
- Those with myeloid immunophenotype, lactate dehydrogenase level ≥1227 IU/L, platelet count < 102 K/μL, no history of stem cell transplantation, transition to BP from chronic phase/accelerated phase, and the presence of chromosome 15 aberrations also had significant increased death risk.
- Achievement of major hematologic response and/or complete cytogenetic response to first-line treatment predicted better survival.
Jain P, Kantarjian H, Ghorab A, et al. 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. [Published online ahead of print July 25, 2017]. Cancer. doi:10.1002/cncr.30864.
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