Prognostic assessment for Chronic Myelomonocytic Leukemia in the context of the World Health Organization 2016 proposal: a multicenter study of 297 patients

FANTL, DOROTEA; ENRICO, ALICIA; CALVACANTI DE ANDRADE SILVA, MARCELA; ARBELBIDE, JORGE; CORREA, WALTER A; PINTOS, NOEMÍ; LARRIPA, IRENE; RODRIGUES PEREIRA VELLOSO, ELVIRA; GONZALEZ, JACQUELINE; PERUSINI, AGUSTINA; MACEDO LIMA, WALTER; FLORES, GABRIELA; BELLI, CAROLINA

Cophenague

Simposio; 15th International Symposium on Myelodysplastic Syndromes; 2019

Myelodysplastic Foundation

Chronic Myelomonocytic Leukemia (CMML) is a clonal disorder sharing features of myelodysplastic syndromes (MD) and myeloproliferative (MP) disorders. The WHO 2016 proposes to subdivide them into CMML-0, -1 and -2, according to the peripheral and bone marrow blasts. Different scoring systems have been developed before that up-date, including the CPSS, and the IPSS and its revised version (IPSS-R) have excluded the MP-variant.Our objective was to evaluate different variables, including the WHO 2016 proposal, and prognostic scoring systems both for overall survival (OS) and evolution to acute myeloid leukemia (AML) in the Latin American context. We evaluated 297 patients with CMML (217-Argentina and 80-Brazil) with a median age of 70 years old (15-95) and a gender M/F ratio: 2.1. With a median overall survival of 30.8 months (IC95% 24.5-37.1), 76 (25.6%) patients evolved to AML and 187 (63.0%) died. All parameters and the three CPSS variants (including the transfusion dependency, Hb cut-points of 10g/dL or according to gender) the IPSS and IPPS-R analyzed were useful to predict the outcome in our cohort (Kaplan-Meier and log-rank test, p