Real‐world data of chronic myelomonocytic leukemia: A chinese single‐center retrospective study. (8th February 2021)

• Record Type: Journal Article
• Authors: Ma, Liya; Jiang, Lingxu; Yang, Wenli; Luo, Yingwan; Mei, Chen; Zhou, Xinping; Xu, Gaixiang; Xu, Weilai; Ye, Li; Ren, Yanlin; Lu, Chenxi; Lin, Peipei; Jin, Jie; Tong, Hongyan
• Is Part Of: Cancer medicine. Volume 10:Number 5(2021)
• Page Start: 1715
• Page End: 1725
• Publication Date: 2021-02-08
• Subjects: chemotherapy -- chronic myelomonocytic leukemia -- hypomethylating agents -- leukemia‐free survival -- overall response rate -- overall survival; 616.994005
• DOI: 10.1002/cam4.3774
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Chronic myelomonocytic leukemia (CMML) is a rare disease of elderly people characterized by the presence of sustained peripheral blood monocytosis, overlapping features of myeloproliferation, and myelodysplasia. We present a large retrospective study of 156 CMML patients in China. Mean age at diagnosis was 68 years old (range 23‐91). According to the CMML‐specific prognostic scoring system (CPSS), 10 patients (8.3%) were low risk, 27 patients (22.5%) were intermediate‐1 risk, 72 patients (60%) were intermediate‐2 risk, and 11 patients (9.2%) were high risk. A total of 90 patients (57.7%) received hypomethylating agents (HMAs) treatment, 19 patients (12.2%) received chemotherapy and 47 patients (30.1%) received the best supportive care. Seventeen patients (10.9%) underwent allogeneic hematopoietic stem cell transplantation (allo‐SCT) after HMAs treatment or chemotherapy. With a median follow‐up of 35.3 months, overall response rate (ORR) was 69.5% in the HMAs ± chemotherapy group, 79.5% in the HMAs monotherapy group, 60.0% in the HMAs + chemotherapy group, and 37.5% in the chemotherapy group. HMAs monotherapy group had prolonged OS compared with the chemotherapy group (23.57 months vs. 11.73 months; p = 0.035). Patients who achieved ORR had prolonged OS (25.83 months vs. 8.00 months; p < 0.001) and LFS (20.53 months vs. 6.80 months; p < 0.001) compared with those not achieved ORR in the HMA ± chemotherapy group. By univariate analysis, only higher hemoglobulin (≥80 g/L) and lower serum LDH levels (<300 U/L) predicted for better OS and LFS. By multivariate analysis, only Hb ≥ 80 g/L predicted for prolonged OS, Hb ≥ 80 g/L, and monocytes < 3 × 109/L predicted for prolonged LFS. In summary, our study highlights the benefit of HMAs therapy in CMML, but we still need to develop novel therapeutics to achieve better outcomes. Abstract : Our retrospective study showed an advantage of HMAs therapy in CMML with an overall response rate of 65.9%‐79.5% compared with chemotherapy. The patients who respond to HMAs treatment have increased survival benefit compared to those who did not respond to HMAs treatment. HMAs monotherapy group had prolonged OS than the chemotherapy group.