Dysplastic versus proliferative CMML - a retrospective analysis of 91 patients from a single institution

In chronic myelomonocytic leukemia (CMML) segregation of two subtypes has b een suggested depending on WBC countmyelodysplastic (MD-CMML) and myeloprol iferative (MP-CMML). In a retrospective analysis of 91 (60/31) previously u ntreated CMML patients, we compared the presenting clinical, haematological , laboratory and bone marrow features and examined the clinical impact of t his reclassification. LDH values and bone marrow cellularity were significa ntly increased in MP-CMML. Median survival was significantly longer for pat ients with MD-CMML, progression rate was higher for MP-CMML. Patients with MD-CMML had longer median preleukemic duration; after transition to AML, MP -CMML patients had longer median survival. In MDS phase anemia was more com mon in MP-CMML and thrombocytopenia more common in MD-CMML whereas transfus ion rates showed no difference. Evaluation of prognostic scoring systems fo r both groups confirmed that patients' characteristics and outcome could be well compared. Our data suggest that segregation into MD-CMML and MP-CMML is justified. (C) 2001 Elsevier Science Ltd. All rights reserved.