Analyses on clinical characteristic and prognoses of 41 patients with chronic myelomonocytic leukemia in China

Abstract 

Purpose

To investigate clinical characteristic and prognostic factors for chronic myelomonocytic leukemia (CMML).

Methods

A retrospective cohort study was used in the research. We investigated clinical and laboratory characteristics of CMML patients and survival status. Patients were followed up regularly through out the course of the research.

Results

Forty-one cases were diagnosed as CMML, including 27 male and 14 female patients. Median WBC was 13.7×10⁹/L. Five patients had leukocytopenia (1.92–3.46×10⁹/L). Median monocyte count in the peripheral blood was 2.13×10⁹/L. All patients presented with bone marrow dysplasia, and most showed hyperplasia, except 3 cases. Abnormal chromosome was detected in 34% cases. Median survival time for CMML-1 and CMML-2 was 20 and 12 months, respectively, but there were no statistical significance of survival duration between them. Univariable analysis showed that age (>60 years), neutrophil count (<2.0×10⁹/L), lymphocyte count (<1.0×10⁹/L), mature monocyte count (≥5×10⁹/L) and anemia (Hb<60g/L) were associated with poor prognosis for CMML. There was no statistical significance in LDH, gender, and abnormal chromosome for survival time. Only lymphocyte count and neutrophil count in peripheral blood were independent prognostic factors for CMML after multivariate analysis.

Conclusion

CMML mainly occurs in elderly patients. Although most patients have leukocytosis and monocytosis at diagnosis, few cases show leucopenia and monocytopenia. Age, neutrophil, lymphopenia, monocytosis, and severe anemia are associated with inferior prognosis of CMML. Lymphocyte<1.0×10⁹/L and neutrophil count<2.0×10⁹/L are adversely independent prognostic factors for CMML.

Keywords: Leukemia/chronic myelomonocytic, Prognosis, Chromosome, Retrospective cohort study, Survival time