Prognostic value of a new clinically-based classification system in patients with CMML undergoing allogeneic HCT: a retrospective analysis of the EBMT-CMWP.
(2022) Bone Marrow Transplantation — Vol. 57, n° 6, p. 896-902 (2022)
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- Authors
Onida, Francesco 
Radujkovic, Aleksandar Yakoub-Agha, Ibrahim
- Abstract
- Recently a new three-group clinical classification was reported by an International Consortium to stratify CMML patients with regard to prognosis. The groups were defined as follows: (1) Myelodysplastic (MD)-CMML: WBC ≤ 10 × 10/l, circulating immature myeloid cells (IMC) = 0, no splenomegaly; (2) MD/MP (overlap)-CMML: WBC 10-20 × 10/l or WBC ≤ 10 × 10/l but IMC > 0 and/or splenomegaly; (3) Myeloproliferative (MP)-CMML: WBC > 20 × 10/l. By analysing EBMT Registry patients who underwent allo-HCT for CMML between 1997 and 2016, we aimed to determine the impact of this classification on transplantation outcome and to make a comparison with the conventional WHO classification (CMML-0/CMML-1/CMML-2). Patient grouping was based on the data registered at time of transplantation, with IMC replaced by peripheral blasts. Among 151 patients included in the analysis, 38% were classified as MD-CMML, 42% as MD/MP-CMML and 20% as MP-CMML. With a median survival of 17 months in the whole series, MD-CMML patients were distinguished as a low-risk group with higher CR rate at transplant and a longer post-transplant 2-year progression-free survival in comparison to others (44.5% vs 33.5%, respectively), whereas the WHO classification was superior in identifying high-risk patients (CMML-2) with inferior survival outcomes.
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Citations
Onida, F., Sbianchi, G., Radujkovic, A., Sockel, K., Kröger, N., Sierra, J., Socié, G., Cornelissen, J., Poire, X., Raida, L., Bourhis, J. H., Finke, J., Passweg, J., Salmenniemi, U., Schouten, H. C., Beguin, Y., Martin, S., Deconinck, E., Ganser, A., et al. (2022). Prognostic value of a new clinically-based classification system in patients with CMML undergoing allogeneic HCT: a retrospective analysis of the EBMT-CMWP. Bone Marrow Transplantation, 57(6), 896-902. https://doi.org/10.1038/s41409-021-01555-9 (Original work published 2022)