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Chronic myelomonocytic leukemia in the light of the WHO proposals

From the Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany (UG, CS, SK, AK, RH, NG); Department of Human Genetics, Heinrich-Heine-University, Düsseldorf, Germany (BH); Department of Hematology, Oncology and Clinical Immunology, St. Johannes Hospital, Duisburg, Germany (CA); University of Rochester Medical Center, USA (JMB)

Correspondence: Ulrich Germing, Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University Moorenstr. 5, 40225 Düsseldorf, Germany. E-mail: germing{at}med.uni-duessel-dorf.de

The WHO classification moved CMML to myeloproliferative/myelodysplastic disorders, and defined CMML I and CMML II according to medullary and peripheral blast count. To confirm these proposals, we analyzed 266 patients with CMML I and 73 patients with CMML II. Median survival time was 20 months for CMML I, and 15 months for CMML II (p<0.005). The cumulative risk of AML evolution differed between patient groups (p=0.001). No conclusive differences in clinical, morphologic, hematologic or cytogenetic parameters were found. These data support the WHO proposals for the classification of CMML.

Key words: myelodysplastic syndromes, myeloproliferative syndromes, CMML, prognosis, WHO classification.