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CML in accelerated or blast phase: ≥10% blasts in PB or BM (accelerated), ≥20% blasts (bl...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-CML-TRANSFORMATION-PROGRESSION
TypeSignal d’alerte
Étatreviewed 2026-04-25 | pending_clinical_signoff
MaladiesDIS-CML
SourcesSRC-ELN-CML-2020 SRC-ESMO-CML-2017 SRC-NCCN-MPN-2025

Origine du drapeau rouge

DéfinitionCML in accelerated or blast phase: ≥10% blasts in PB or BM (accelerated), ≥20% blasts (blast phase), or extramedullary blasts. Treatment intent shifts from chronic-phase TKI to acute-leukemia-style induction + alloHCT.
Direction cliniqueen attente
Catégorietransformation-progression
Algorithme de décalageALGO-CML-1L

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "cml_phase",
      "value": "accelerated"
    },
    {
      "finding": "cml_phase",
      "value": "blast"
    },
    {
      "comparator": ">=",
      "finding": "blasts_pb_pct",
      "threshold": 10
    },
    {
      "comparator": ">=",
      "finding": "blasts_bm_pct",
      "threshold": 10
    },
    {
      "finding": "extramedullary_blasts",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

Triggers HOLD on chronic-phase 1L algorithm. Accelerated/blast-phase CML is a clinical emergency: high-dose 2nd/3rd-gen TKI (dasatinib 140 mg or ponatinib if T315I), urgent donor search for alloHCT, induction chemotherapy (myeloid blast: AML-style 7+3; lymphoid blast: hyperCVAD + TKI). Plan generation does not proceed with chronic-phase regimen selection — describes the blast-phase workup. Priority bumped to 10. STUB — requires clinical co-lead signoff.

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