Chronic myelomonocytic leukemia

Last revised by Yuranga Weerakkody on 10 Feb 2022

Chronic myelomonocytic leukemia (CMML) is a relatively rare clonal hematologic disorder. In the World Health Organizatiοn classification, it is listed as a disorder with features of both myelodysplastic syndromes and myeloproliferative neoplasms.

Can be variable but many patients tend to present with fatigue, weight loss, fever, and night sweats.

It is usually characterized by accumulation of monocytes in the blood and bone marrow, dysplastic hematopoiesis. 

The diagnosis is characterized by:

  • peripheral monocytosis (>1x109/L)
  • absence of Philadelphia chromosome and BCR/ABL fusion gene
  • fewer than 20% lymphoblasts in the blood or bone marrow
  • dysplasia involving one or more myeloid lineages

Two types of CMML have been described. 

  • type 1: has less than 5% blasts (immature blood cells)
  • type 2: has between 5-20% blasts in the blood

The clinical course is variable. There is potential for leukemic involvement of organs. Blood transfusions and erythropoietin (EPO) administration may play a role in correcting low hemoglobin levels in cases with anemia.​

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