Contributions
Abstract: PB2110
Type: Publication Only
Background
Chronic myelomonocytic leukaemia (CMML) represents a clonal hematopoietic disorder with myelodysplastic and myeloproliferative features. Some CMML cases are similar to a myelodysplastic syndrome with persistent blood monocytosis (MDS-CMML). Other cases present with leucocytosis, neutrophilia, persistent peripheral blood monocytosis and splenomegaly and are similar to a myeloproliferative syndrome (MPN-CMML). According to the 2016 WHO classification CMML is classified into 3 groups based on the peripheral/ bone marrow blast count: CMML-0, CMML-1, CMML-2.
Aims
The aim of this study was to analyse the features and treatment response in the CMML patients in our centre.
Methods
Between 2011- 2017, in our clinic, 38 patients met the criteria for CMML and were reclassified according to the 2016 WHO classification for the purpose of this retrospective study. The median monitoring time was 18 months.
Results
There were 25 (65.79 %) men and 13 (34.21 %) women, with a sex ratio ♂/♀= 1.9. Women presented a younger median age at diagnosis 62 years (47, 67) vs men 68 years (62, 75), (p=0,025), with an overall median age of 66 years (59, 75). The majority of patients were over 60 years old at diagnosis (73.68 %). Half the patients presented multiple cardiovascular comorbidities at diagnosis.
In this lot, 16 patients (42.1 %) were categorized as MPN-CMML and 22 patients as MDS-CMML (57.9 %). According to the WHO 2016 classification 13 patients (34.21 %) were CMML-0, 11 patients (28.95 %) CMML-1 and 14 patients (36.84 %) CMML-2. There was a statistically significant difference between the median value for leukocytes (p<0,001), neutrophils (p<0,001) and monocytes (p<0,001) for MDS-CMML and MPL-CMML, but not regarding the median value for haemoglobin, platelets, bone marrow blast and LDH level. Between the 3 WHO groups no statistically significant difference was observed for the median value for leucocytes, neutrophils, monocytes platelets and haemoglobin. The difference between the median LDH levels for the three groups was statistically significant (p=0.038).
The transformation rate to AML for this lot was 34.2%, with a median time to progression of 17 months and a survival time of 2.2 months afterwards. No difference regarding the transformation rate for the 2 groups (MDS-CMML, MPN-CMML) respectively the 3 groups (CMML-0, CMML-1, CMML-2) was observed. The median survival time for CMML-0 was 32 months, for CMML-1 25 months and for CMML-2 18 months with an overall median survival time of 32 months. Regarding the treatment, 8 patients (21.05 %) received hypomethylating agents, 9 patients (23.68 %) received Hydroxycarbamide and 2 patients (10.52 %) received intensive chemotherapty including allogeneic stem cell transplant (1 patient ongoing at 47 months after allogeneic stem cell transplant, while another died 3 months after the same procedure). No statistically significant difference was found between these treatment groups for our study.
Conclusion
We conclude that CMML is a heterogeneous disease, mostly affecting the elderly with a reserved outcome. The only curative treatment with an impact on survival is allogeneic stem cell transplantation.
Session topic: 10. Myelodysplastic syndromes – Clinical
Keyword(s): Chronic myelomonocytic leukemia, Myelodysplasia
Abstract: PB2110
Type: Publication Only
Background
Chronic myelomonocytic leukaemia (CMML) represents a clonal hematopoietic disorder with myelodysplastic and myeloproliferative features. Some CMML cases are similar to a myelodysplastic syndrome with persistent blood monocytosis (MDS-CMML). Other cases present with leucocytosis, neutrophilia, persistent peripheral blood monocytosis and splenomegaly and are similar to a myeloproliferative syndrome (MPN-CMML). According to the 2016 WHO classification CMML is classified into 3 groups based on the peripheral/ bone marrow blast count: CMML-0, CMML-1, CMML-2.
Aims
The aim of this study was to analyse the features and treatment response in the CMML patients in our centre.
Methods
Between 2011- 2017, in our clinic, 38 patients met the criteria for CMML and were reclassified according to the 2016 WHO classification for the purpose of this retrospective study. The median monitoring time was 18 months.
Results
There were 25 (65.79 %) men and 13 (34.21 %) women, with a sex ratio ♂/♀= 1.9. Women presented a younger median age at diagnosis 62 years (47, 67) vs men 68 years (62, 75), (p=0,025), with an overall median age of 66 years (59, 75). The majority of patients were over 60 years old at diagnosis (73.68 %). Half the patients presented multiple cardiovascular comorbidities at diagnosis.
In this lot, 16 patients (42.1 %) were categorized as MPN-CMML and 22 patients as MDS-CMML (57.9 %). According to the WHO 2016 classification 13 patients (34.21 %) were CMML-0, 11 patients (28.95 %) CMML-1 and 14 patients (36.84 %) CMML-2. There was a statistically significant difference between the median value for leukocytes (p<0,001), neutrophils (p<0,001) and monocytes (p<0,001) for MDS-CMML and MPL-CMML, but not regarding the median value for haemoglobin, platelets, bone marrow blast and LDH level. Between the 3 WHO groups no statistically significant difference was observed for the median value for leucocytes, neutrophils, monocytes platelets and haemoglobin. The difference between the median LDH levels for the three groups was statistically significant (p=0.038).
The transformation rate to AML for this lot was 34.2%, with a median time to progression of 17 months and a survival time of 2.2 months afterwards. No difference regarding the transformation rate for the 2 groups (MDS-CMML, MPN-CMML) respectively the 3 groups (CMML-0, CMML-1, CMML-2) was observed. The median survival time for CMML-0 was 32 months, for CMML-1 25 months and for CMML-2 18 months with an overall median survival time of 32 months. Regarding the treatment, 8 patients (21.05 %) received hypomethylating agents, 9 patients (23.68 %) received Hydroxycarbamide and 2 patients (10.52 %) received intensive chemotherapty including allogeneic stem cell transplant (1 patient ongoing at 47 months after allogeneic stem cell transplant, while another died 3 months after the same procedure). No statistically significant difference was found between these treatment groups for our study.
Conclusion
We conclude that CMML is a heterogeneous disease, mostly affecting the elderly with a reserved outcome. The only curative treatment with an impact on survival is allogeneic stem cell transplantation.
Session topic: 10. Myelodysplastic syndromes – Clinical
Keyword(s): Chronic myelomonocytic leukemia, Myelodysplasia