Patients With Therapy-Related CMML Have Shorter Median Overall Survival Than Those With De Novo CMML: Mayo Clinic Long-Term Follow-Up Experience

Salih Subari, Mrinal M Patnaik, Dima Alfakara, Naseema Gangat, Michelle Elliott, William Hogan, Mark R Litzow, Aref Al-Kali

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background Chronic myelomonocytic leukemia (CMML) is a malignant hematologic neoplasm characterized by peripheral blood monocytosis and bone marrow dysplasia. The World Health Organization classified therapy-related (t-) myeloid neoplasm (MN) as another category. It is known that t-MNs tend to have a worse prognosis than de novo (dn-) MN (dn-MN). Patients and Methods Previous exposure to chemotherapy (CT), radiotherapy (RT), or both were defined as t-CMML and lack of both as dn-CMML. Results Of 265 CMML patients, 30 (11%) had t-CMML. Seventeen (57%) patients had previous exposure to CT, 6 (20%) to RT, and 7 (23%) to CT and RT. Leukemic transformation (LT) was seen in 5 (17%). In comparison, only lower platelet count was found to be statistically significant compared with dn-CMML. Median overall survival (OS) was 20 months in the dn-CMML group versus 11 months in the t-CMML group (P =.02). Median OS was 9 months in the CT group versus 4.4 months in the RT group versus 13 months in the CT and RT group (P =.7). Conclusion t-CMML comprises a small portion of all CMML cases (11%). Median OS in the dn-CMML group was longer than in the t-CMML group but LT seemed to be similar in terms of incidence and time to occurrence. Additional studies are needed to confirm our results.

Original languageEnglish (US)
Article number614
Pages (from-to)546-549
Number of pages4
JournalClinical Lymphoma, Myeloma and Leukemia
Volume15
Issue number9
DOIs
StatePublished - Sep 1 2015

Keywords

  • Chronic myelomonocytic leukemia
  • Hypomethylation
  • Leukemic transformation
  • Survival
  • Treatment-related

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology
  • Medicine(all)

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