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Significance of cardiovascular comorbidity in patients with chronic myelomonocytic leukemia

David Lackner1, Klaus Geissler2,3

  • 1Medical School, Sigmund Freud University, Vienna, Austria.

Wiener Medizinische Wochenschrift (1946)
|November 22, 2022
PubMed

Insights

Cardiovascular comorbidities are common in chronic myelomonocytic leukemia (CMML). These conditions did not impact survival but were linked to fewer blasts and a lower risk of disease transformation in CMML patients.

Area of Science:

  • Hematology
  • Oncology
  • Cardiology

Background:

  • Chronic myelomonocytic leukemia (CMML) is a heterogeneous myeloid neoplasm.
  • Cardiovascular comorbidities are frequently observed in patients with CMML.
  • The prognostic significance of these comorbidities in CMML is not well-defined.

Purpose of the Study:

  • To investigate the prevalence of cardiovascular comorbidities in CMML patients.
  • To assess the prognostic impact of these comorbidities on survival and disease transformation.
  • To explore correlations between cardiovascular comorbidity and laboratory/molecular features.

Main Methods:

  • Retrospective analysis of 310 CMML patients.
  • Documentation and analysis of common cardiovascular comorbidities (coronary heart disease, atrial fibrillation, hypertension).
  • Statistical evaluation of prognostic impact and correlations with clinical/molecular data.

Main Results:

  • 36% of CMML patients had documented cardiovascular comorbidities.
  • Coronary heart disease, atrial fibrillation, and hypertension were the most frequent.
  • No significant impact on overall survival was observed.
  • Patients with comorbidities showed lower circulating blast counts and fewer EZH2 mutations.
  • Time to transformation was significantly longer in patients with cardiovascular comorbidity.

Conclusions:

  • Cardiovascular comorbidity is prevalent but does not significantly impact survival in CMML.
  • An unexpected finding was a lower transformation rate in CMML patients with cardiovascular comorbidity.
  • Further research is warranted to understand the mechanisms behind the reduced transformation rate.

Keywords:
Cardiovascular diseaseChronic myelomonocytic leukemiaCoronary heart diseaseSurvivalTime to transformation

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