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Chronic myelogenous leukemia in blast crisis: retrospective analysis of prognostic factors in 90 patients.

Abstract：

:Ninety patients with Philadelphia chromosome-positive chronic myelogenous leukemia in blast crisis were reviewed to identify significant prognostic associations. At diagnosis of blast crisis the main clinical, laboratory, and cytogenetic data were recorded and evaluated for prognostic significance. At the time of the analysis 89 patients had died, with a median survival of 11 weeks from diagnosis of blast crisis. Patient characteristics demonstrated in the univariate analysis to have significant association with shorter survival were: thrombocythemia, leukocyte count above 20 x 10(9), Karnofsky index < 50%, nonlymphoid blast cell morphology, cytogenetic clonal evolution, the presence of a double Philadelphia chromosome or trisomy 8, and no response to therapy. In 17 of 59 patients (29%) evaluable for response to therapy a complete or partial remission was achieved. These responders had a significantly longer median survival (25 weeks) as compared with nonresponders (9 weeks). Response to therapy was significantly better in lymphoid blast crisis and in patients without clonal evolution. In a multivariate analysis containing all significant variables of the univariate analysis two parameters retained their prognostic significance: response to therapy and trisomy 8. In spite of the short overall survival in blast crisis, the determination of prognostic factors may be a useful tool for the clinician planning therapy, especially new therapeutic approaches.

journal_name

Ann Hematol

journal_title

Annals of hematology

authors

Griesshammer M,Heinze B,Hellmann A,Popp C,Anger B,Heil G,Bangerter M,Heimpel H

doi

10.1007/s002770050233

subject

Has Abstract

pub_date

1996-11-01 00:00:00

pages

225-30

issue

5

eissn

0939-5555

issn

1432-0584

journal_volume

73

pub_type

杂志文章

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