Abstract 785P
Background
Cytogenetic abnormalities are a common occurrence in CML Blast phase patients. This study analyses the array of additional cytogenetic abnormalities (ACA) in CML Blast Phase (CML BP) patients, with their clinical presentation, prevalence, complexity and lineage specificity.
Methods
58 subjects in CML Blast phase were prospectively studied from January 2023 to July 2024. The demographic data, presentation, lineage assessment, ACA and survival were evaluated. Conventional cytogenetic study and karyotypic analysis was performed for all cases.
Results
Among the 58 subjects 67.24% were males, and the median age of presentation was 41 years. Fever (72.4%), fatigue (41.3%) and abdominal pain (25.86%) were the most common symptoms. 22.4% cases presented as de-novo blast phase and 77.5% progressed from chronic phase. Extramedullary involvement was seen in 6.89%. Immunophenotype indicated myeloid (65.51%), lymphoid (32.75%) and biphenotypic (1.72%) lineage specificity. Cytogenetics revealed ACAs in 74.13% cases, most common abnormalities were double Ph (44.18%), trisomy 8 (25.58%), trisomy 19 (13.95%) and inversion 3 (11.6%). Among all the cases, 53.48% had complex ACAs (≥2 ACA), while 46.51% has single ACA. Double Ph was the most common ACA among myeloid and lymphoid lineage. Median survival in this study was 14 months at 95% confidence interval (10.955–17.045). No significant prognostic difference was observed between complex vs single ACA (P= 0.147 ) and major vs minor route abnormality (P= 0.815).
Conclusions
Myeloid lineage is most common in CML-BP patients. Common ACAs observed are Double Ph, Trisomy 8, Trisomy 19 and inversion 3. Fever is the most common presenting complaint. Complex ACA has trend towards poorer outcome. Inversion 3, typical of AML and MDS, may suggest poor response to TKI. Due to relatively small sample size, further studies with larger cohorts are warranted.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Kidwai Memorial Institute of Oncology.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.