Journal
ANNALS OF HEMATOLOGY
Volume 100, Issue 6, Pages 1439-1449Publisher
SPRINGER
DOI: 10.1007/s00277-021-04539-3
Keywords
Chronic myelomonocytic leukemia; World Health Organization 2016; Prognosis; Survival; South America
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Funding
- Agencia Nacional de Promocion Cientifica y Tecnologica (ANPCyT) [PICT 0480, PICT 1623]
- Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET) [PIP 0056]
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Limited knowledge on chronic myelomonocytic leukemia (CMML) patients from Argentina and Brazil was addressed in this study. The analysis of 280 patients revealed varied clinical characteristics and survival outcomes among different CMML subtypes, highlighting the importance of prognostic assessment. The study validated several scoring systems and the WHO 2016 proposal for predicting outcomes in CMML patients from Latin America.
Knowledge on chronic myelomonocytic leukemia (CMML) patients from Argentina and Brazil is limited. Our series of 280 patients depicted an older age at diagnosis (median 72 years old), 26% of aberrant karyotypes, and a prevalence of myelodysplastic (60%) and CMML-0 subtypes (56%). The median overall survival (OS) was 48.2 months for patients in CMML-0 (Ref.), 24.7 months for those in CMML-1 (HR = 2.0, p = 0.001), and 8.8 months for patients in CMML-2 (HR = 4.6, p < 0.001). In the CMML-0 category, median OS were different between myelodysplastic and myeloproliferative subtypes (63.7 vs 21.2 months, p < 0.001); however, no differences were observed within CMML-1 and CMML-2 subtypes (24.7 vs 23.7 months, p = 0.540, and 9.1 vs 8.2 months, p = 0.160). The prognostic impact of 24 variables and 7 prognostic systems was adjusted to the WHO 2016 after validating their usefulness. Multivariate analysis were performed, and the final model revealed Hb >= 8 -< 10g/dL (HR 1.7), Hb < 8g/dL (HR 2.8), poor karyotypes (HR 2.1), WHO 2016-CMML-1 (HR 2.1), and CMML-2 (HR 3.5) as independent adverse clinical parameters in our cohort with a borderline influence of platelets count < 50 x 10(9)/L (HR 1.4). We could validate several scoring systems, the WHO 2016 proposal and its prognostic capability, along with accessible covariates, on predicting the outcome in our series of CMML patients from Latin America.
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