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Chronic Myelomonocytic Leukemia: 2018 Update to Prognosis and Treatment

  • Hany Elmariah
  • Amy E. DeZernEmail author
Myeloproliferative Neoplasms (B Stein, Section Editor)
  • 32 Downloads
Part of the following topical collections:
  1. Topical Collection on Myeloproliferative Neoplasms

Abstract

Purpose of Review

Chronic myelomonocytic leukemia (CMML) is a rare and often aggressive myeloid malignancy. Historically, prognostic markers and therapeutic paradigms have been applied from myelodysplastic syndromes (MDS) or myeloproliferative neoplasms (MPNs). Interest has increased recently in developing tailored approaches for the MDS/MPN overlap syndrome of CMML.

Recent Findings

Multiple prognostic scores have been validated specifically for CMML in the past 5 years. These incorporate somatic mutations, with ASXL1 mutations repeatedly correlating with poor prognosis. Accurate prognostication can guide treatment. Hypomethylating agents (HMAs) and curative allogeneic blood or marrow transplantation (BMT) remain the most available standard treatments. Recently, a number of novel approaches using unapproved therapies (i.e., lenalidomide, ruxolitinib, sotatercept, and tipifarnib) have demonstrated some efficacy in CMML.

Summary

Increased recognition and interest in CMML have led to the development of a number of new prognostic models and potential treatment options. Standard treatment options remain limited and clinical trials should be strongly considered whenever available.

Keywords

Chronic myelomonocytic leukemia (CMML) Mayo prognostic model CPSS ASXL1 Hypomethylating agents Allogeneic BMT 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Blood and Marrow Transplantation and Cellular ImmunotherapyH. Lee Moffitt Cancer CenterTampaUSA
  2. 2.Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsThe Johns Hopkins University School of MedicineBaltimoreUSA

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