Contemporary treatment approaches to CMML - Is allogeneic HCT the only cure?

Area of Science:

• Hematology
• Oncology

Background:

• Chronic Myelomonocytic Leukemia (CMML) is a heterogeneous myeloid malignancy primarily affecting older adults.
• Prognostic factors can identify CMML patients with poor survival, including younger individuals eligible for stem cell transplantation.

Purpose of the Study:

• To review the identification of CMML patients suitable for curative therapy.
• To discuss the role, limitations, and management of allogeneic stem cell transplantation (allo-SCT) in CMML.

Main Methods:

• Retrospective data analysis.
• Review of existing literature on CMML and allo-SCT.
• Discussion of patient selection, bridging strategies, transplant management, and post-transplant interventions.

Main Results:

• Allo-SCT is the only curative option for CMML but is feasible for a minority of patients.
• Transplant-related mortality and post-transplant relapse significantly limit its potential.
• Various strategies exist to bridge patients to transplant and manage the procedure itself.

Conclusions:

• Curative therapy via allo-SCT should be considered for select CMML patients.
• Further prospective studies are essential to optimize allo-SCT outcomes in CMML.