Sudden onset of the blastic phase of chronic myelogenous leukemia : Patterns and implications (pages 81–85)
Hagop Kantarjian, Susan O'Brien, Jorge Cortes, Francis Giles, Deborah Thomas, Steven Kornblau, Jianquin Shan, Mary Beth Rios, Michael Keating, Emil Freireich and Moshe Talpaz
Version of Record online: 16 MAY 2003 | DOI: 10.1002/cncr.11477
A sudden onset of the blastic phase of chronic myelogenous leukemia (CML) is a worrisome event that reduces the curative potential of allogeneic stem cell transplantation (SCT) in patients who have received nonallogeneic SCT frontline strategies. Among 1093 patients analyzed between 1981–2001, 183 patients developed a blastic phase, which was of sudden onset in 46 patients (25%; 4% of the total). The incidence of sudden blastic phase was 2.2% during the first 2 years. No poor-prognosis factors were found to predict for sudden blastic phase. However, the sudden onset of blastic-phase disease was found more often to be lymphoid in origin and was associated with a high response rate to blastic-phase therapy (response rate of 70% vs. 29%; P < 0.0001) and better survival (median of 12 months vs. 6 months; P < 0.012). Therefore, sudden blastic phase appears to be uncommon in CML.