Chronic myelomonocytic leukemia

Chronic myelomonocytic leukemia
Peripheral blood film of CMML. Monocytosis and the presence of myelocytes, metamyelocytes and promyelocytes is typical of CMML.
SpecialtyHaematology, oncology
CausesEnvironmental carcinogens, ionising radiation, cytotoxic agents
Diagnostic methodBlood film, genetic testing
FrequencyLess than 1 per 100,000 per year

Chronic myelomonocytic leukemia (CMML) is a type of leukemia, which are cancers of the blood-forming cells of the bone marrow. In adults, blood cells are formed in the bone marrow, by a process that is known as haematopoiesis. In CMML, there are increased numbers of monocytes and immature blood cells (blasts) in the peripheral blood and bone marrow, as well as abnormal looking cells (dysplasia) in at least one type of blood cell.[1]

CMML shows characteristics of a myelodysplastic syndrome (MDS); a disorder that produces abnormal looking blood cells, and a myeloproliferative neoplasm (MPN); a disorder characterised by the overproduction of blood cells. For this reason, CMML was reclassified as a MDS/MPN overlap disorder in 2002.[2] For a diagnosis of CMML, the World Health Organization (WHO) states that the blood monocyte count must be >1x109/L, no Philadelphia chromosome or mutations in the PDGFRA or PDGFRB gene should be present, the blast count must be <20% and dysplasia of at least one lineage of myeloid blood cell should be present.[3]

Azacitidine is a drug used to treat CMML and is approved by the Food and Drug Administration (FDA) and the European Medicines Agency. Stem cell transplant is also used to treat CMML, and involves the transplantation of donor haematopoietic stem cells into the recipient. Blood transfusion and erythropoietin are used to treat disease associated anaemia.[4][5][6]

  1. ^ Foucar K (August 2009). "Myelodysplastic/myeloproliferative neoplasms". Am. J. Clin. Pathol. 132 (2): 281–9. doi:10.1309/AJCPJ71PTVIKGEVT. PMID 19605822.
  2. ^ Vardiman JW, Harris NL, Brunning RD (October 2002). "The World Health Organization (WHO) classification of the myeloid neoplasms". Blood. 100 (7): 2292–302. doi:10.1182/blood-2002-04-1199. PMID 12239137.
  3. ^ Vardiman J, Hyjek E (2011). "World health organization classification, evaluation, and genetics of the myeloproliferative neoplasm variants". Hematology. 2011: 250–6. doi:10.1182/asheducation-2011.1.250. PMID 22160042.
  4. ^ Cite error: The named reference pmid20856790 was invoked but never defined (see the help page).
  5. ^ Robert J. Soiffer (17 November 2008). Hematopoietic Stem Cell Transplantation. Springer. ISBN 978-1-934115-05-3. Retrieved 23 September 2012.
  6. ^ Cite error: The named reference pmid12057067 was invoked but never defined (see the help page).