Data from a European blast phase registry (n=240; blast phase defined as ≥20% blasts or extramedullary disease; 2015-2023 data) reported a median overall survival of 23.8 months (median follow-up 27.8 months).[6]Brioli A, Lomaia E, Fabisch C, et al. Management and outcome of patients with chronic myeloid leukemia in blast phase in the tyrosine kinase inhibitor era - analysis of the European LeukemiaNet Blast Phase Registry. Leukemia. 2024 May;38(5):1072-1080.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11073984
http://www.ncbi.nlm.nih.gov/pubmed/38548962?tool=bestpractice.com
Median overall survival of approximately 12 months was reported in one retrospective chart review of patients in blast crisis (n=477; blast phase defined as ≥30% blasts or extramedullary disease; 1997-2016 data) who were treated with a tyrosine kinase inhibitor at some point during the course of their disease.[7]Jain P, Kantarjian HM, 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. Cancer. 2017 Nov 15;123(22):4391-402.
https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.30864
http://www.ncbi.nlm.nih.gov/pubmed/28743165?tool=bestpractice.com
Chronic myeloid leukaemia (CML)
CML is usually diagnosed in its chronic form (as opposed to its accelerated or blast forms), which, if untreated, will progress to fatal blastic disease within 3-5 years.[8]Cortes JE, Talpaz M, Kantarjian H. Chronic myelogenous leukemia: a review. Am J Med. 1996 May;100(5):555-70.
http://www.ncbi.nlm.nih.gov/pubmed/8644769?tool=bestpractice.com
Less than 5% of CML patients present in an advanced phase, although some patients will progress to accelerated or blast phase despite treatment.[9]Hoffmann VS, Baccarani M, Hasford J, et al. Treatment and outcome of 2904 CML patients from the EUTOS population-based registry. Leukemia. 2017 Mar;31(3):593-601.
http://www.ncbi.nlm.nih.gov/pubmed/27568522?tool=bestpractice.com
In one study, 10-year cumulative incidence of transformation to the blast phase was 5.8% for patients with chronic-phase CML treated with imatinib as initial therapy.[10]Hehlmann R, Lauseker M, Saußele S, et al. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants. Leukemia. 2017 Nov;31(11):2398-2406.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5668495
http://www.ncbi.nlm.nih.gov/pubmed/28804124?tool=bestpractice.com
The median age at diagnosis of CML in the US is 66 years, although the disease can occur at any age.[11]National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: leukemia - chronic myeloid leukemia (CML). 2024 [internet publication].
https://seer.cancer.gov/statfacts/html/cmyl.html
In developing countries, median age at diagnosis is <50 years.[12]Malhotra H, Radich J, Garcia-Gonzalez P. Meeting the needs of CML patients in resource-poor countries. Hematology Am Soc Hematol Educ Program. 2019 Dec 6;2019(1):433-42.
https://ashpublications.org/hematology/article/2019/1/433/422617/Meeting-the-needs-of-CML-patients-in-resource-poor
http://www.ncbi.nlm.nih.gov/pubmed/31808889?tool=bestpractice.com
In the US, CML is more common in males compared with females (2.5 vs. 1.5, respectively, per 100,000 people).[11]National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: leukemia - chronic myeloid leukemia (CML). 2024 [internet publication].
https://seer.cancer.gov/statfacts/html/cmyl.html
In the US in 2024, it is estimated that there will be 9280 new cases of CML, and 1280 deaths associated with CML.[11]National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: leukemia - chronic myeloid leukemia (CML). 2024 [internet publication].
https://seer.cancer.gov/statfacts/html/cmyl.html