Onkologie. 2015:9(6):298-303

Diagnosis and treatment of chronic myelomonocytic leukemia - a view from clinical practice

Peter Rohoň1, Petra Bělohlávková2, Zuzana Rusiňáková1, Vít Procházka1, Eva Kadlčková3, Luděk Raida4, Alžběta Zavřelová2, Marie Jarošová1, Pavel Žák2, Karel Indrák1
1 Hemato-onkologická klinika FN a LF UP v Olomouci
2 IV. interní hematologická klinika FN Hradec Králové
3 Hematologicko-transfuzní oddělení, Krajská nemocnice T. Bati Zlín, a.s.

Chronic myelomonocytic leukemia (CMML) is a hematopoietic stem cells disorder, it carries myelodysplastic and myeloproliferative

features. CMML occurs rarely, especially in the elderly, and often transforms into acute myelogenous leukemia. Recently, in a large proportion

of patients sophisticated molecular-biology technologies can determine mutations in epigenetic regulatory genes (e.g. TET2,

ASXL1, …) that modify chromatin condensation and also gene expression. These facts support the inclusion of hypomethylating agents

(HMA) in the standard treatment of CMML and opened the gates for the use of other new molecules. The aim of this paper is to describe

concrete examples of current diagnostics and treatment of CMML and demonstrate the complexity of the new approaches.

Keywords: chronic myelomonocytic leukemia, hypomethylating agents, allogeneic stem cell transplantation

Published: December 1, 2015  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Rohoň P, Bělohlávková P, Rusiňáková Z, Procházka V, Kadlčková E, Raida L, et al.. Diagnosis and treatment of chronic myelomonocytic leukemia - a view from clinical practice. Onkologie. 2015;9(6):298-303.
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References

  1. Zoi K, Cross NC. Molecular pathogenesis of atypical CML, CMML and MDS/MPN-unclassifiable. Int J Hematol 2015; 101: 229-242. Go to original source... Go to PubMed...
  2. Parikh SA, Tefferi A. Chronic myelomonocytic leukemia: 2012 update on diagnosis, risk stratification, and management. Am J Hematol 2012; 87: 610-619. Go to original source... Go to PubMed...
  3. Rollison DE, Howlader N, Smith MT, et al. Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001-2004, using data from the NAACCR and SEER programs. Blood 2008;112: 45-52. Go to original source... Go to PubMed...
  4. Greenberg P, Cox C, LeBeau MM, et al. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood 1997; 89: 2079-2088. Go to original source...
  5. Such E, Germing U, Malcovati L, et al. Development and validation of a prognostic scoring system for patients with chronic myelomonocytic leukemia. Blood 2013; 121: 3005-3015. Go to original source... Go to PubMed...
  6. Rohoň P, Bělohlávková P, Rusiňáková Z, et al. Diagnostika a liečba chronickej myelomonocytovej leukémie v rokoch 2000-2013: výsledky z dvoch hematologických centier. Onkológia 2014; 9: 188-192.
  7. Tefferi A, Elliott MA, Pardanani A. Atypical myeloproliferative disorders: diagnosis and management. Mayo Clin Proc 2006; 81: 553-563. Go to original source... Go to PubMed...
  8. Onida F, Barosi G, Leone G, et al. Management recommendations for chronic myelomonocytic leukemia: consensus statements from the SIE, SIES, GITMO groups. Haematologica 2013; 98: 1344-1352. Go to original source... Go to PubMed...
  9. Laport GG, Sandmaier BM, Storer BE, et al. Reduced intensity conditioning followed by allogeneic hematopoietic cell transplantation for adult patients with myelodysplastic syndrome and myeloproliferative disorders. Biol Blood Marrow Transplant 2008; 14: 246-255. Go to original source... Go to PubMed...
  10. Swerdlow SH, Campo E, Harris NL. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues Lyon: IARC Press, 2008.
  11. Bennett JM, Catovsky D, Daniel MT, et al. The chronic myeloid leukaemias: guidelines for distinguishing chronic granulocytic, atypical chronic myeloid, and chronic myelomonocytic leukaemia. Proposals by the French-American-British Cooperative Leukaemia Group. Br J Haematol. 1994; 87: 746-754. Go to original source... Go to PubMed...
  12. Sorror ML, Maris MB, Storb R, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 2005; 106: 2912-2919. Go to original source... Go to PubMed...
  13. Elliott MA, Tefferi A, Hogan WJ, et al. Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia. Bone Marrow Transplant 2006; 11: 1003-1008. Go to original source... Go to PubMed...
  14. Such E, Cervera J, Costa D, et al. Cytogenetic risk stratification in chronic myelomonocytic leukemia. Haematologica 2011; 96: 375-383. Go to original source... Go to PubMed...
  15. Wattel E, Guerci A, Hecquet B, et al. A randomized trial of hydroxyurea versus VP16 in adult chronic myelomonocytic leukemia. Groupe Francais des Myelodysplasies and European CMML Group. Blood 1996; 88: 2480-2487. Go to original source...
  16. Zandberg DP, Huang TY, Ke X, et al. Treatment and outcomes for chronic myelomonocytic leukemia compared to myelodysplastic syndromes in older adults. Haematologica 2013; 98: 584-590. Go to original source... Go to PubMed...
  17. Perez C, Martinez-Calle N, Martin-Subero JI, et al. TET2 mutations are associated with specific 5 - cmethylcytosine and 5-hydroxymethylcytosine profiles in patients with chronic myelomonocytic leukemia. PLoS ONE 2012; 7: e31605. Go to original source... Go to PubMed...
  18. Jonášová A, Čermák J, Červinek L, et al. První zkušenosti České MDS skupiny s terapií 5-azacytidinem u nemocných s myelodysplastickým syndromem s vyšším rizikem (IPSS střední 2 a vysoké riziko), akutní myeloidní leukemií do 30 % myeloblastů a chronickou myelomonocytární leukemií II. Transfuze Hematol dnes 2013; 3: 125-133.
  19. Costa R, Abdulhaq H, Haq B, et al. Activity of azacitidine in chronic myelomonocytic leukemia. Cancer 2011; 117: 2690-2696. Go to original source... Go to PubMed...
  20. Fianchi L, Criscuolo M, Breccia M, et al. High rate of remissions in chronic myelomonocytic leukemia treated with 5-azacytidine: Results of an Italian retrospective study. Leuk Lymphoma 2013; 54: 658-661. Go to original source... Go to PubMed...
  21. Wong E, Seymour JF, Kenealy M, et al. Treatment of chronic myelomonocytic leukemia with azacitidine. Leuk Lymphoma 2013; 54: 878-880. Go to original source... Go to PubMed...
  22. Pleyer L, Germing U, Sperr WR, et al. Azacytidine in CMML: Matched-pair analyses of daily-life patients reveal modest effects on clinical course and survival. Leuk Research 2014; 38: 475-483. Go to original source... Go to PubMed...
  23. Padron E, Steensma DP. Cutting the cord from myelodysplastic syndromes: chronic myelomonocytic leukemia-specific biology and management strategies. Curr Opin Hematol 2015; 22: 163-170. Go to original source... Go to PubMed...
  24. Chapman CM, Sun X, Roschewski M, et al. ON 01910.Na is selectively cytotoxic for chronic lymphocytic leukemia cells through a dual mechanism of action involving PI3K/AKT inhibition and induction of oxidative stress. Clin Cancer Res 2012; 18: 1979-1991. Go to original source... Go to PubMed...




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