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Chronic Myelomonocytic Leukemia
Chronic myelomonocytic leukemia (CMML) is a clonal disorder of a bone marrow stem cell. The clinical, hematological, and morphologic features of CMML are heterogeneous, ranging from predominantly myelodysplastic to predominantly myeloproliferative.1 The blood and bone marrow of patients with CMML often show evidence of both myeloid cell dysplasia and proliferation. CMML is distinguished from chronic myeloid leukemia (CML), in part, by peripheral blood monocytosis in the absence of the Ph chromosome and Bcr-Abl transcript.2
The World Health Organization (WHO) classifies CMML into 2 prognostic subcategories—CMML-1 and CMML-2—based on number of blast cells in the blood and bone marrow.3 The higher the blast count, the poorer the prognosis.
Epidemiology
The median age of presentation of patients with CMML is approximately 73 years, with a slight male predominance.4 The incidence of CMML is unknown due to differences among epidemiologic studies in the way the disorder has been classified.1
References:
- National Cancer Institute. Myelodysplastic/Myeloproliferative Diseases (PDQ®): Treatment. Health Professional Version. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/mds-mpd/healthprofessional/allpages. Accessed April 24, 2006.
- Germing U, Gattermann N, Minning H, Heyll A, Aul C. Problems in the classification of CMML—dysplastic versus proliferative type. Leuk Res. 1998;22:871-878.
- Vardiman JW, Harris NL, Brunning RD. The World Health Organization (WHO) classification of the myeloid neoplasms. Blood. 2002;100:2292-2302.
- Bowen DT. Chronic myelomonocytic leukemia: lost in classification? Hematol Oncol. 2005;23:26-33.
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