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Leuk Res. 2014 Dec;38(12):1413-9. doi: 10.1016/j.leukres.2014.09.003. Epub 2014 Sep 17.

Refined medullary blast and white blood cell count based classification of chronic myelomonocytic leukemias.

Author information

1
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany. Electronic address: Esther.Zipperer@med.uni-duesseldorf.de.
2
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany.
3
Department of Human Genetics and Anthropology, Heinrich-Heine-University, Düsseldorf, Germany.

Abstract

Since 2001, chronic myelomonocytic leukemia (CMML) is classified by the WHO as myeloproliferative/myelodysplastic neoplasm. Herein we tried to better describe CMML patients with regard to hematological characteristics and prognosis using data of the Duesseldorf registry. We created 6 CMML subgroups, by dividing dysplastic and proliferative CMML at the cut-off of white blood cell count of 13,000/μL and splitting these two groups into 3 subgroups: CMML 0 with <5% blasts (n=101), CMML I with 5-9% blasts (n=204) and CMML II with 10-19% blasts (n=81). For comparison we included patients with RCMD, RAEB I and II. The newly created CMML 0 group had better prognosis than CMML I and II, median survival times were 31 months (ms), 19ms and 13ms, respectively (p<0.001). Median survival times between the corresponding dysplastic and proliferative subgroups 0 and 1 differed significantly: CMML 0 dysplastic 48ms and CMML 0 proliferative 17ms (p=0.03), CMML I dysplastic 29ms and CMML I proliferative 15ms (p=0.008), CMML II dysplastic 17ms and CMML II proliferative 10ms (p=0.09). Outcome of CMML patients worsens with increasing medullary blasts and when presenting as proliferative type. Therefore it is justified to separate CMML with <5% medullary blasts.

KEYWORDS:

CMML; CPSS; MDS; MDS/MPN; Overlap; Prognosis

PMID:
25444076
DOI:
10.1016/j.leukres.2014.09.003
[Indexed for MEDLINE]

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