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Chronic myelomonocytic leukemia: natural history and prognostic determinants.

Abstract
A retrospective clinical review of 41 patients with chronic myelomonocytic leukemia revealed a median age of 66 years and a male:female ratio of 2.4:1. The disease was preceded by a myelodysplastic syndrome of a different subtype in 24% of the patients and transformed into acute leukemia in 24%. Splenomegaly was present in 54% of the patients and reached massive proportions in 24%. Chromosomal abnormalities occurred in 34% of those studied, most commonly in the younger age group; the most frequent were trisomy 8, monosomy 7, and deletions involving the long arms of chromosomes 20 and X. Polyclonal hypergammaglobulinemia was detected in 47% of the patients in whom serum protein electrophoresis was done. The median survival was 3 years. With use of univariate analysis, the statistically significant prognostic determinants were hemoglobin level, the "modified Bournemouth score," and bone marrow blast cell percentage. When these factors were subjected to a multivariate analysis, only bone marrow blast cell percentage was an independent prognostic determinant. Orally administered hydroxyurea controlled leukocytosis and splenomegaly in some patients without affecting the overall prognosis.
AuthorsA Tefferi, H C Hoagland, T M Therneau, R V Pierre
JournalMayo Clinic proceedings (Mayo Clin Proc) Vol. 64 Issue 10 Pg. 1246-54 (Oct 1989) ISSN: 0025-6196 [Print] England
PMID2593715 (Publication Type: Journal Article)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Chromosome Aberrations
  • Chromosome Disorders
  • Female
  • Humans
  • Infant
  • Leukemia, Myelomonocytic, Chronic (diagnosis, genetics, mortality)
  • Leukocytes
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes (complications)
  • Prognosis
  • Splenomegaly (complications)
  • Stem Cells

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