Accelerated phase chronic myeloid leukemia: Evaluation of clinical criteria as predictors of survival, major cytogenetic response and progression to blast phase

Abstract

Background: Published criteria defining the accelerated phase in chronic myeloid leukemia are heterogeneous and little is known about predictors of poor outcome. Methods: This is a retrospective study of 139 subjects in the accelerated phase of chronic myeloid leukemia treated with imatinib at a single center in Brazil. The objective was to identify risk factors for survival, major cytogenetic response and progression to blast phase in this population. The factors analyzed were: blasts 10-29%, basophils≥20%, platelets>1×106/μL or <1×105/μL and white blood cells>1×105/μL in the peripheral blood, as well as clonal evolution, splenomegaly, hemoglobin<10g/dL, time between diagnosis of chronic myeloid leukemia and imatinib treatment, and hematologic toxicity. Results: Risk factors for poor survival in multivariate analysis were Grades 3-4 hematologic toxicity (p-value = 0.001), blasts 10-29% (p-value = 0.023), and hemoglobin. . 12 months (p-value = 0.030). Conclusion: These data indicate that patients with the above risk factors have a worse prognosis. This information can guide the therapy to be used.