Prognostic value of a new clinically-based classification system in patients with CMML undergoing allogeneic HCT: a retrospective analysis of the EBMT-CMWP

TY - JOUR

T1 - Prognostic value of a new clinically-based classification system in patients with CMML undergoing allogeneic HCT: a retrospective analysis of the EBMT-CMWP

AU - Onida, Francesco

AU - Sbianchi, Giulia

AU - Radujkovic, Aleksandar

AU - Sockel, Katja

AU - Kröger, Nicolaus

AU - Sierra, Jorge

AU - Socié, Gerard

AU - Cornelissen, Jan

AU - Poiré, Xavier

AU - Raida, Luděk

AU - Bourhis, Jean Henri

AU - Finke, Jürgen

AU - Passweg, Jakob

AU - Salmenniemi, Urpu

AU - Schouten, Harry C

AU - Beguin, Yves

AU - Martin, Sonja

AU - Deconinck, Eric

AU - Ganser, Arnold

AU - Zver, Samo

AU - Lioure, Bruno

AU - Rohini, Radia

AU - Koster, Linda

AU - Hayden, Patrick

AU - Iacobelli, Simona

AU - Robin, Marie

AU - Yakoub-Agha, Ibrahim

N1 - © 2021. The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2022/6

Y1 - 2022/6

N2 - 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 × 109/l, circulating immature myeloid cells (IMC) = 0, no splenomegaly; (2) MD/MP (overlap)-CMML: WBC 10-20 × 109/l or WBC ≤ 10 × 109/l but IMC > 0 and/or splenomegaly; (3) Myeloproliferative (MP)-CMML: WBC > 20 × 109/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.

AB - 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 × 109/l, circulating immature myeloid cells (IMC) = 0, no splenomegaly; (2) MD/MP (overlap)-CMML: WBC 10-20 × 109/l or WBC ≤ 10 × 109/l but IMC > 0 and/or splenomegaly; (3) Myeloproliferative (MP)-CMML: WBC > 20 × 109/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.

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Leukemia, Myelomonocytic, Chronic

KW - Prognosis

KW - Retrospective Studies

U2 - 10.1038/s41409-021-01555-9

DO - 10.1038/s41409-021-01555-9

M3 - SCORING: Journal article

C2 - 35352038

VL - 57

SP - 896

EP - 902

JO - BONE MARROW TRANSPL

JF - BONE MARROW TRANSPL

SN - 0268-3369

IS - 6

ER -