Chronic Myelomonocytic Leukemia: 2018 Update to Prognosis and Treatment

AbstractPurpose of ReviewChronic myelomonocytic leukemia (CMML) is a rare and often aggressive myeloid malignancy. Historically, prognostic markers and therapeutic paradigms have been applied from myelodysplastic syndromes (MDS) or myeloproliferative neoplasms (MPNs). Interest has increased recently in developing tailored approaches for the MDS/MPNoverlap syndrome of CMML.Recent FindingsMultiple prognostic scores have been validated specifically for CMML in the past 5  years. These incorporate somatic mutations, withASXL1 mutations repeatedly correlating with poor prognosis. Accurate prognostication can guide treatment. Hypomethylating agents (HMAs) and curative allogeneic blood or marrow transplantation (BMT) remain the most available standard treatments. Recently, a number of novel approaches using unapproved therapies (i.e., lenalidomide, ruxolitinib, sotatercept, and tipifarnib) have demonstrated some efficacy in CMML.SummaryIncreased recognition and interest in CMML have led to the development of a number of new prognostic models and potential treatment options. Standard treatment options remain limited and clinical trials should be strongly considered whenever available.
Source: Current Hematologic Malignancy Reports - Category: Hematology Source Type: research