Table 1. Clinical and laboratory features and subsequent events in 261 ‘young' (age⩽65 years) adults with WHO-defined chronic myelomonocytic leukemia, stratified by allogenic stem cell transplant status.
| Variable | All patients n=261 | Transplanted patents n=53 (24%) | Non-transplant patients n=167 (76%) | P-value |
|---|---|---|---|---|
| Age in years; median (range) | 59 (18–65) | 52 (18–65) | 60 (20–65) | <0.0001 |
| Males; n (%) | 192 (73%) | 32 (60%) | 128 (77%) | 0.02 |
| Hemoglobin g/dl; median (range) | 11.0 (4.2–17.7) | 10.1 (4.2–15.5) | 10.9 (4.9–17.7) | 0.006 |
| WBC × 109/l; median (range) | 12.4 (1.8–180.0) | 14.8 (2.5–133.0) | 11.4 (1.8–180) | 0.08 |
| ANC × 109/l; median (range) | 5.7 (0.2–151) | 5.9 (0.3–92.6) | 5.3 (0.2–151) | 0.5 |
| AMC × 109/l; median (range) | 2.6 (0.3–62.8) | 3.1 (0.6–62.8) | 2.6 (0.3–44) | 0.3 |
| ALC × 109/l; median (range) | 2.1 (0–12.5) | 2.6 (0.3–12.5) | 2.0 (0–8.1) | 0.01 |
| Platelets × 109/l; median (range) | 99 (6–1427) | 72 (6–1064) | 107 (10–1427) | 0.1 |
| PB blast % median (range) | 0 (0–16) | 0 (0–16) | 0 (0–16) | 0.1 |
| BM blast % median (range) | 4 (0–18) | 6 (0–18) | 4 (0–16) | 0.001 |
| Circulating immature myeloid cells; n (%) ‘N' evaluable=258 | 141 (55%) | 29 (55%) | 86 (52%) | 0.8 |
| WHO morphological subtype; n (%) | ||||
| CMML-1 | 219 (84%) | 36 (68%) | 146 (87%) | 0.001 |
| CMML-2 | 42 (16%) | 17 (32%) | 21 (13%) | — |
| ASXL1 mutations; ‘N' evaluable=174 | 58 (33%) | 7 (28%) | 37 (34%) | 0.6 |
| SETBP1 mutations; ‘N' evaluable=164; n (%) | 7 (4%) | 0 (0%) | 4 (4%) | 0.3 |
| Spliceosome component mutations; | ||||
| SF3B1 ‘N' evaluable=113 | 9 (8%) | 1 (6%) | 5 (9%) | 0.7 |
| SRSF2 ‘N' evaluable=161 | 72 (45%) | 8 (33%) | 47 (48%) | 0.2 |
| U2AF1 ‘N' evaluable=111 | 5 (4%) | 1 (6%) | 3 (5%) | 0.9 |
| Spanish cytogenetic risk stratification; ‘N' evaluable=246 n (%) | ||||
| Low | 196 (80%) | 40 (75%) | 124 (78%) | 0.7 |
| Intermediate | 28 (11%) | 6 (11%) | 20 (13%) | — |
| High | 22 (9%) | 7 (13%) | 15 (9%) | — |
| Mayo-French cytogenetic risk stratification; ‘N' evaluable=246, n(%) | ||||
| Low | 200 (81%) | 40 (75%) | 126 (79%) | 0.6 |
| Intermediate | 39 (16%) | 12 (23%) | 27 (17%) | — |
| High | 7 (3%) | 1 (2%) | 6 (4%) | — |
| MD Anderson prognostic risk categories; n (%) ‘N' evaluable=254 | ||||
| Low | 111 (44%) | 17 (33%) | 74 (46%) | 0.02 |
| Intermediate-1 | 51 (20%) | 17 (33%) | 50 (31%) | — |
| Intermediate-2 | 85 (33%) | 13 (25%) | 35 (67%) | — |
| High | 7 (3%) | 5 (10%) | 2 (1%) | — |
| Mayo Model prognostic risk categories; n (%) ‘N' evaluable=259 | ||||
| Low | 65 (25%) | 9 (17%) | 48 (29%) | 0.1 |
| Intermediate | 92 (36%) | 18 (34%) | 58 (35%) | — |
| High | 102 (39%) | 26 (49%) | 59 (36%) | — |
| Mayo Molecular Model ‘N' evaluable=171 | ||||
| Low | 20 (12%) | 1 (4%) | 13 (12%) | — |
| Intermediate-1 | 46 (26%) | 5 (20%) | 31 (29%) | 0.1 |
| Intermediate-2 | 61 (36%) | 8 (32%) | 39 (37%) | — |
| High | 44 (26%) | 11 (44%) | 23 (22%) | — |
| GFM prognostic risk categories; n (%) ‘N' evaluable=171 | ||||
| Low | 106 (62%) | 12 (48%) | 68 (64%) | 0.2 |
| Intermediate | 61 (36%) | 13 (52%) | 35 (33%) | — |
| High | 4 (2%) | 0 (0%) | 3 (3%) | — |
| — | — | — | — | |
| Leukemic transformations; n (%) ‘N' evaluable=258 | 72 (28%) | — | — | — |
| Before transplant | — | 19 (36%) | 41 (24%) | — |
| After transplant | — | 5 (9%) | — | — |
| Deaths; n (%) | 126 (48%) | 25 (47%) | 92 (55%) | 0.3 |
Abbreviations: ALC, absolute lymphocyte count; AMC, absolute monocyte count; ANC, absolute neutrophil count; ASXL1, additional sex combs 1 gene; BM, bone marrow; CMML, chronic myelomonocytic leukemia; GFM, Groupe Francais des Myelodsyplasies; PB, peripheral blood; SF3B1, splicing factor 3B, subunit 1; SRSF2, serine/arginine-rich splicing factor 2; U2AF1, U2 small nuclear RNA auxiliary factor 1; WBC, white blood cell count; WHO, World Health Organization.
Mayo-French cytogenetic risk stratification: Low risk, normal karyotype, −Y and sole der (3q); high risk, complex and monosomal karyotype; intermediate all other karyotype abnormalities; Spanish cytogenetic risk stratification: Low risk, −Y and normal karyotype; high risk, +8, −chromosome 7 abnormalities and complex karyotype: intermediate risk, all other abnormalities. Bold entries signify statistically significant P-values (i.e. P<0.05).