Real-World CMML Data: Treatment Outcomes, Predictors of Survival

A retrospective study published in Cancer Medicine provided real-world data on patients with chronic myelomonocytic leukemia (CMML) in China.

The study included 156 patients with CMML, with a mean age of 68 years (range, 23-91 years). Patients were stratified by risk level using the CMML-specific prognostic scoring system (CPSS); and were classified as low-risk (n=10, 8.3%), intermediate-1 risk (n=27, 22.5%), intermediate-2 risk (n=72, 60%), and high-risk (n=11, 9.2%).

Regarding treatment, most patients received hypomethylating agents (HMAs; n=90, 57.7%), followed by the best supportive care (n=47, 30.1%) and chemotherapy (n=19, 12.2%); 17 patients (10.9%) also received allogeneic hematopoietic stem cell transplantation (allo-SCT) after HMAs treatment or chemotherapy.

Median follow-up was 35.3 months. Overall response rates (ORRs) by treatment were: HMAs ± chemotherapy, 69.5%; HMAs monotherapy, 79.5%; HMAs + chemotherapy, 60%; and chemotherapy, 37.5%. Overall survival (OS) was much longer in the HMAs monotherapy group than the chemotherapy group (23.57 months vs. 11.73 months; P=0.035). In the HMA ± chemotherapy group, patients who attained ORR, compared to those who did not, had superior OS (25.83 months vs. 8 months; P<0.001) and leukemia-free survival (LFS; 20.53 months vs. 6.8 months; P<0.001).

The only factors predictive of better OS and LFS in univariate analysis were hemoglobulin ≥80 g/L and serum lactate dehydrogenase levels <300 U/L. Upon multivariate analysis, hemoglobulin ≥80 g/L was the only predictor of better OS, while predictors of better LFS were hemoglobulin ≥80 g/L and monocytes <3 × 109/L.