Chronic myelomonocytic leukemia - a review

Area of Science:

• Hematology
• Oncology
• Molecular Biology

Background:

• Chronic myelomonocytic leukemia (CMML) is a clonal myeloid neoplasm with overlapping myelodysplastic and myeloproliferative features.
• CMML is characterized by poor survival rates and a high risk of transformation to acute myeloid leukemia.

Purpose of the Study:

• To provide a comprehensive review of diagnostic criteria, pathogenesis, and genetic landscape of CMML.
• To discuss prognostication, response criteria, and therapeutic management, including established and novel treatment modalities.

Main Methods:

• A thorough Medline search of pertinent published literature was conducted.
• Review of diagnostic criteria, pathogenesis, genetic landscape, prognostication, response criteria, and therapeutic management.

Main Results:

• CMML exhibits abundant cytogenetic abnormalities and gene mutations affecting epigenetic regulation, transcription, and cell signaling.
• These mutations have prognostic implications and are integrated into risk-stratification schemes.
• Novel response criteria have been proposed, and allogeneic stem cell transplantation is the only curative option, but is limited to a few patients.

Conclusions:

• There is a significant unmet need for optimizing existing treatments like hypomethylating agents and developing novel agents for CMML.
• Further clinical trials are essential to evaluate the efficacy and safety of new treatment modalities to improve survival and quality of life for CMML patients.