Evidence map›Paper›PMID 40332442›Full record

ArticleBlood2025

BLAST: a globally applicable and molecularly versatile survival model for chronic myelomonocytic leukemia.

Ayalew Tefferi, Saubia Fathima, Maymona Abdelmagid, Ali Khalid A Alsugair, Fnu Aperna, Mahsa Rezasoltani, Muhammad Yousuf, Anuya Natu, Clifford M Csizmar, Mark Gurney and 25 more

Abstract read
In one paragraph

Article in Blood, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Article
  7. Molecular-Based Ecosystem to Improve Personalized Medicine in Chronic Myelomonocytic Leukemia.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026
    Article
  8. Article
  9. Article
  10. Multidrug-resistantVeterinary world · 2026
    Article
  11. Article
  12. [How I diagnose and treat chronic myelomonocytic leukemia].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2026
    Article
  13. Article
  14. Article
  15. Impact of Epigenetic Mutations in Chronic Myelomonocytic Leukemia.Current hematologic malignancy reports · 2025
    Review
  16. Allogeneic Transplant for CMML.Current hematologic malignancy reports · 2025
    Review
  17. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

35 authors.

Ayalew TefferiDivision of Hematology, Mayo Clinic, Rochester, MN.
Saubia FathimaDivision of Hematology, Mayo Clinic, Rochester, MN.ORCID 0000-0002-9979-7923
Maymona AbdelmagidDivision of Hematology, Mayo Clinic, Rochester, MN.
Ali Khalid A AlsugairDivision of Hematology, Mayo Clinic, Rochester, MN.
Fnu ApernaDivision of Hematology, Mayo Clinic, Rochester, MN.
Mahsa RezasoltaniDivision of Hematology, Mayo Clinic, Rochester, MN.
Muhammad YousufDivision of Hematology, Mayo Clinic, Rochester, MN.
Anuya NatuDivision of Hematology, Mayo Clinic, Rochester, MN.
Clifford M CsizmarDivision of Hematology, Mayo Clinic, Rochester, MN.ORCID 0000-0002-1221-8854
Mark GurneyDivision of Hematology, Mayo Clinic, Rochester, MN.
Terra L LashoDivision of Hematology, Mayo Clinic, Rochester, MN.
Christy M FinkeDivision of Hematology, Mayo Clinic, Rochester, MN.
Rashmi Kangal-ShamannaDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-7829-5249
Danielle HammondDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0002-6017-2264
Kelly ChienDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-6024-1613
Alexandre BazinetDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Courtney D DiNardoDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-9003-0390
Tapan M KadiaDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Abhishek A MangaonkarDivision of Hematology, Mayo Clinic, Rochester, MN.
Naval DaverDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-7103-373X
Animesh PardananiDivision of Hematology, Mayo Clinic, Rochester, MN.
Gautam BorthakurDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Cinthya Zepeda-MendozaDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Kaaren K ReichardDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Rong HeDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.ORCID 0000-0001-6116-8163
Sanam LoghaviDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0001-8980-3202
Francesco PassamontiDipartimento di Oncologia ed Onco-Ematologia, Università degli Studi di Milano, Milan, Italy.
Farhad RavandiDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Koji SasakiDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.ORCID 0000-0002-9140-0610
Dirk R LarsonDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.ORCID 0000-0002-2970-2124
Guillermo Garcia-ManeroDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Francesco OnidaHematology and Bone Marrow Transplant Center, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Università degli Studi di Milano, Milan, Italy.ORCID 0000-0002-2991-3474
Naseema GangatDivision of Hematology, Mayo Clinic, Rochester, MN.ORCID 0000-0002-9104-6172
Guillermo Montalban-BravoDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Mrinal M PatnaikDivision of Hematology, Mayo Clinic, Rochester, MN.ORCID 0000-0001-6998-662X

Funding

Targeting PLK1 in RAS mutant chronic myelomonocytic leukemiaR01CA272496 · NCI · MAYO CLINIC ROCHESTER · PI Mrinal Shiv Patnaik · 2023 to 2026
$1.7M
NCI NIH HHS R01 CA272496
6 · The paper itself

Abstract

abstractWe sought to develop a survival model in chronic myelomonocytic leukemia (CMML) that is primarily based on clinical variables and examine additional impact from mutations and karyotype. A total of 457 molecularly annotated patients were considered. Multivariable analysis identified circulating blasts ≥2% (1 point), leukocytes ≥13 × 109/L (1 point), and severe (2 points) or moderate (1 point) anemia as preferred risk variables in developing a clinical risk stratification tool for overall survival (OS), acronymized to "BLAST": low risk (0 points; median, 63 months); intermediate risk (1 point; median, 28 months; hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.6-3.0), and high risk (2-4 points; median, 13 months; HR, 5.4; 95% CI, 4.1-7.3); the corresponding 3/5-year OS rates were 68%/53%, 43%/18%, and 12%/1%. BLAST model performance (area under the receiver operating characteristic curve [AUC] 0.77/0.85 at 3/5 years) was shown to be comparable to that of the molecular CMML-specific prognostic scoring system (AUC 0.73/0.75) and the international prognostic scoring system-molecular (AUC 0.73/0.74). Multivariable analysis of mutations and karyotype identified PHF6MUT and TET2MUT as being "favorable" and DNMT3AMUT, U2AF1MUT, BCORMUT, SETBP1MUT, ASXL1MUT, NRASMUT, PTPN11MUT, RUNX1MUT, TP53MUT, and adverse karyotype, "unfavorable." Molecular information was subsequently encoded in a combined clinical-molecular risk model (BLAST-mol; AUC 0.80/0.86 at 3/5 years) that included the aforementioned BLAST clinical risk variables and a 3-tiered molecular risk score. BLAST and BLAST-mol were subsequently validated by 2 separate external cohorts. Independent risk factors for blast transformation included DNMT3AMUT, ASXL1MUT, PHF6WT, leukocytes ≥13 × 109/L, and ≥2% circulating or ≥10% bone marrow blasts. The current study proposes an easy-to-implement, globally applicable, and molecularly adaptive risk model for CMML.

Indexed as

Blast CrisisLeukemia, Myelomonocytic, ChronicAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedMutationPrognosisSurvival Rate

Identifiers

PMID40332442
PMCPMC12883847

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.