CMML is in the eye of the be-WHO-lder: interrogating the newly proposed entity of oligomonocytic CMML: MDS or CMML?

The World Health Organization and international consensus 2022 classifications have proposed lowering the absolute monocyte monocyte: A large white blood cell. Monocytes move through the blood to the tissues where they become macrophages. Macrophages are immune cells that surround and kill germs such as bacteria and viruses. count threshold to ≥ 0.5 × 109/L for the diagnosis of chronic myelomonocytic leukemia (CMML). This was based on reports describing patients with oligomonocytic CMML (O-CMML) (0.5 × 109/L to 1.0 × 109/L) as a CMML variant. We identified patients among the myelodysplastic syndrome (MDS) database with O-CMML who meet the new criteria for CMML and compared them to MDS and CMML (≥1.0 × 109/L). Among 1861 patients with MDS, 468 (25%) were O-CMML meeting new CMML criteria. The genomic landscape of O-CMML was more comparable to MDS. Classical CMML somatic mutations (TET-2, ASXL-1 and SRSF2) frequencies were closer to MDS. Proliferative CMML (P-CMML) mutations were less common. DNMT3A and TP53 mutations were more commonly observed in MDS and O-CMML compared to CMML. SF3B1 SM was observed in 29% of O-CMML compared to 16% in MDS, 8% dysplastic CMML (D-CMML) and 5% P-CMML (P < .005). Thirteen patients (2.8%) progressed from O-CMML to CMML. The rate of acute myeloid leukemia acute myeloid leukemia: (uh-KYOOT my-uh-LOYD loo-KEE-mee-uh) A cancer of the blood cells. It happens when very young white blood cells (blasts) in the bone marrow fail to mature. The blast cells stay in the bone marrow and become to numerous. This slows production of red blood cells and platelets. Some cases of MDS become… transformation was less than MDS and P-CMML. The hazard ratio for overall survival was 1.2 (95% confidence interval [CI], 1.03-1.4; P = .018) for O-CMML, 1.3 (95% CI, 1.07-1.58; P = .008) for D-CMML and 1.87 for P-CMML (95% CI, 1.57-2.4; P = .005) compared to MDS after adjusting for molecular international prognostic scoring system international prognostic scoring system: A system that turns patient data into a score. The score tells how quickly a myelodysplastic syndrome (MDS) case is progressing and helps predict what may happen with the patient's MDS in the future. Also called IPSS. . Although O-CMML may be a unique entity, the current classification does not enrich CMML-like variants by all clinical measures. A comprehensive analysis of clinical, molecular and immunophenotype is needed for better classification.