Clinical and Prognostic Features in a series of 277 patients with Chronic Myelomonocytic Leukemia (CMML) from South America: a multicenter study

GONZALEZ, JACQUELINE; PERUSINI, AGUSTINA; DE DIOS SOLER, MARCELA; MACEDO LIMA, WALTER; LARRIPA, IRENE; ARBELBIDE, JORGE; FANTL, DOROTEA; SANTOS, ISABEL; ROCHA, VANDERSON; BESTACH, YESICA; BELLI, CAROLINA; ROMAGNOLI, CARLA; ROSENHAIN, MARIANA; RODRIGUES PEREIRA VELLOSO, ELVIRA; FLORES, GABRIELA

Valencia

Simposio; 14th Symposium on Myelodysplastic Syndromes; 2017

Myelodysplastic Foundation

CMML is a clonal disorder sharing features of myelodysplastic syndromes (MD) and myeloproliferative (MP) disorders. The CMML Prognostic Scoring System (CPSS) was designed specifically for CMML patients. Recently, the WHO committee proposed classifying them into: CMML-0, -1 and 2 according to the presence of bone marrow and peripheral blasts. Since both proposals have not been widely reproduced, our aim was to evaluate different prognostic factors for survival and evolution to AML, to validate the CPSS and the WHO classification in a series of 277 patients with CMML from South America (197-Argentina and 80-Brazil).CMML patients showed a median age of 72.6 (range 15-95) years, being 83.6% older than 60 years, with a gender ratio M/F: 2.1. With a median overall survival of 32.6 months, 61(22.0%) evolved to AML and 157(56.7%) died. The distribution of patients according to CMML-MD/MP subtypes: 162/107; normal/elevated LDH: 128/105, CPSS-karyotypes (Good-175, Intermediate-18, Poor-36). These and other variables were evaluated including transfusion requirement, cut-point values for cytopenias according to the CPSS and IPSS-R, and hemoglobin level adjusted by gender. All those parameters, the WHO 2016 proposal and all CPSS variant were useful to predict outcome in our population (Kaplan Meier and log-rank test, p