Clinical and Molecular Approach to Adult-Onset, Neoplastic Monocytosis

AbstractPurpose of ReviewIn this review, we provide a comprehensive and contemporary understanding of malignant monocytosis and provide a framework by which the appropriate diagnosis with malignant monocytosis can be rendered.Recent FindingsIncreasing data support the use of molecular data to refine the diagnostic approach to persistent monocytosis. The absence of aTET2,SRSF2, orASXL1 mutation has ≥ 90% negative predictive value for a diagnosis of CMML. These data may also reliably differentiate chronic myelomonocytic leukemia, the malignancy that is most associated with mature monocytosis, from several other diseases that can be associated with typically a lesser degree of monocytosis. The se include acute myelomonocytic leukemia, acute myeloid leukemia with monocytic differentiation, myelodysplastic syndromes, and myeloproliferative neoplasms driven byBCR-ABL1,PDGFRA,PDGFRB, orFGFR1 rearrangements orPCM1-JAK2 fusions among other rarer aberrations. The combination of monocyte partitioning with molecular data in patients with persistent monocytosis may increase the predictive power for the ultimate development of CMM but has not been prospectively validated.SummaryMany conditions, both benign and malignant, can be associated with an increase in mature circulating monocytes. After reasonably excluding a secondary or reactive monocytosis, there should be a concern for and investigation of malignant monocytosis, which includes hematopathologic review of blood and marrow tissue...
Source: Current Hematologic Malignancy Reports - Category: Hematology Source Type: research