Characteristics and Outcome of Patients with Chronic Myelomonocytic Leukemia: Experience of a Single Center

Creative Commons License

Aslan candir B., BOZAN E., YAMAN S., Seçilmiş S., BAŞCI S., YİĞENOĞLU T. N., ...Daha Fazla

ACTA ONCOLOGICA TURCICA, cilt.56, sa.1, ss.27-32, 2023 (TRDizin)

Özet

Introduction: Chronic myelomonocytic leukemia (CMML) is a condition that overlaps with myelodysplastic syndrome and myeloproliferative neoplasms. The prognosis is generally poor, with a median survival of 20 to 40 months and approximately 15-30% of patients progressing to acute myeloid leukemia (AML). We aimed to evaluate the characteristics and outcomes of CMML patients who were treated at our institution. Material and methods: A retrospective cohort study examined data from 14 CMML patients between January 2013 and January 2022. Results: The median age of fourteen patients at diagnosis was 66 years (min 43-max 84 years). Only one patient (7.1%) had the JAK 2 V617F mutation. Most of the patients had CMML stage-0 disease (64.3%) and 13 patients had the proliferative type of disease. Nine patients were treated with hydroxyurea, which resulted in two responders. Eight patients were treated with azacitidine, which resulted in three responders. During follow-up, AML transformation was observed in five patients (35.7%) and the median duration between diagnosis and AML transformation was 12 months (10-33 months). In the AML-transformed group, at the time of diagnosis, the percentage of neutrophils was lower (52.5% vs 72.3%), and the percentage of monocytes was higher (27% vs 15.6%). In AML-transformed group the total disease duration was longer (21 (11-44) vs 5 (2-48) months) than non-transformed group. Discussion and Conclusion: In patients receiving hypomethylating agents and hydroxyurea treatments for CMML, adequate response cannot be obtained. The rate of AML transformation increases with disease duration.