Blast phase (BP) of chronic myeloid leukemia (CML) still represents an unmet clinical need with a dismal prognosis. Due to the rarity of the condition and the heterogeneity of the biology and clinical presentation, prospective trials and concise treatment recommendations are lacking. Here we present the analysis of the European LeukemiaNet Blast Phase Registry, an international collection of the clinical presentation, treatment and outcome of blast phases which had been diagnosed in CML patients after 2015. Data reveal the expected heterogeneity of the entity, lacking a clear treatment standard. Outcomes remain dismal, with a median overall survival of 23.8 months (median follow up 27.8 months). Allogeneic stem cell transplantation (alloSCT) increases the rate of deep molecular responses. De novo BP and BP evolving from a previous CML do show slightly different features, suggesting a different biology between the two entities. Data show that outside clinical trials and in a real-world setting treatment of blast phase is individualized according to disease- and patient-related characteristics, with the aim of blast clearance prior to allogeneic stem cell transplantation. AlloSCT should be offered to all patients eligible for this procedure.

3 Med Klinik Med Fakultät Mannheim Universität Heidelberg Mannheim Germany

Abteilung für Innere Medizin 4 Klinikum Wels Grieskirchen Wels Austria

Centre Hospitalier Annecy Genevois Annecy France

Centre Léon Bérard Hématology Départment and CRCL INSERM U590 Lyon France

Department of General Pathology Pomeranian Medical University in Szczecin Szczecin Poland

Department of Haematology University Medical Centre Ljubljana Ljubljana Slovenia

Department of Hemato Oncology University Hospital Olomouc Faculty of Medicine and Dentistry Palacky University in Olomouc Olomouc Czech Republic

Department of Hematology and Bone Marrow Transplantation Poznań University of Medical Sciences Poznań Poland

Department of Hematology Jagiellonian University Medical College Cracow Poland

Department of Hematology Jagiellonian University Medical College Krakow Poland

Department of Hematology University Hospital Uppsala Uppsala Sweden

Department of Internal Medicine Hematology and Oncology University Hospital Brno and Masaryk University Brno Czech Republic

Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Università di Bologna Bologna Italy

Faculty of Pharmacy University of Ljubljana Ljubljana Slovenia

Hematology and Oncology Faculty of Medicine University of Augsburg Augsburg Germany

Hematology Center after Prof R Yeolyan Yerevan Armenia

Hematology Department Institute of Hematology and Transfusion Medicine Warsaw Poland

Hematooncology Department Copernicus Memorial Hospital Lodz Poland

Institut für Medizinische Informationsverarbeitung Biometrie und Epidemiologie Medizinische Fakultät Ludwig Maximilians Universität München Munich Germany

Institute of Hematology and Blood Transfusion Prague Czech Republic

IRCCS Azienda Ospedaliero Universitaria di Bologna Istituto di Ematologia Seràgnoli Bologna Italy

Klinik für Hämatologie Hämostaseologie Onkologie und Stammzelltransplantation Medizinische Hochschule Hannover Hannover Germany

Klinik für Innere Medizin 2 Universitätsklinikum Jena Comprehensive Cancer Center Central Germany Campus Jena Jena Germany

Klinik und Poliklinik für Innere Medizin C Hämatologie und Onkologie Universitätsmedizin Greifswald Greifswald Germany

Klinikum Passau Klinik für Onkologie Hämatologie und Palliativmedizin Passau Germany

Medizinische Klinik 4 Klinikum Bayreuth GmbH Bayreuth and Comprehensive Cancer Center Erlangen EMN Bayreuth Germany

Oncology Centre of the Podkarpackie Province Department of Hematooncology Brzozow Poland

Onkologische Schwerpunktpraxis Anhut Kronach Germany

Raisa Gorbacheva memorial Research Institute for Pediatric Oncology Hematology Transplantation 1st State Pavlov Medical University of Saint Petersburg Saint Petersburg Russian Federation

Research Department of Immuno Oncology Almazov National Medical Research Centre Saint Petersburg Russian Federation

Servicio de Hematología Hospital General Universitario de Toledo Toledo Spain

Uniklinik Erlangen Medizinische Klinik 5 Erlangen Germany

University of Leipzig Medical Center Department of Hematology Cellular Therapy Hemostaseology and Infectious Diseases Comprehensive Cancer Center Central Germany Campus Leipzig Leipzig Germany

Zentrum für Innere Medizin Hämatologie Onkologie Stauferklinikum Schwäbisch Gmünd Mutlangen Germany

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