Chronic Myelomonocytic Leukemia: 2018 Update to Prognosis and Treatment

Hany Elmariah, Amy E. DeZern

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)154-163
Number of pages10
JournalCurrent Hematologic Malignancy Reports
Volume14
Issue number3
DOIs
StatePublished - Jun 15 2019

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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