Combining a tyrosine kinase inhibitor (TKI) with intensive chemotherapy after stem cell transplantation seems to work the best in patients with chronic myeloid leukemia in blast phase (CML-BP), according to a cohort study involving 477 individuals. Participants with CML-BP were treated with a TKI at some point during their illness. Investigators looked at overall and failure-free survival. Among the results:

• 7 in every 10 patients received TKI therapy before CML-BP.
• Median overall and failure-free survival were 12 and 5 months, respectively.
• A TKI/chemo combination conferred the best response.
• Patients ≥58 years of age and those who had previously taken a TKI had significantly increased risk of mortality.
• Those with myeloid immunophenotype, lactate dehydrogenase level ≥1227 IU/L, platelet count < 102 K/μL, no history of stem cell transplantation, transition to BP from chronic phase/accelerated phase, and the presence of chromosome 15 aberrations also had significant increased death risk.
• Achievement of major hematologic response and/or complete cytogenetic response to first-line treatment predicted better survival.