Figure 3.

Therapeutic algorithm for higher-risk CMML patients. ∗According to proposed CMML prognostic scores. ^{45,50,65,87,91@} Indicates nonfit (patients with multiple comorbidities and/or poor performance) or fit (patients with no comorbidities and good performance status). ^† Indicates failure of nontransplant strategies. Nontransplant interventions may include >1 line of nontransplant intervention. ∗∗ Indicates poor-risk features (defined as poor-risk cytogenetics, persistent blast increase [>50% or with >15% BM blasts], life-threatening cytopenias [neutrophil counts, <0.3 × 10⁹/L; platelet counts, <30 × 10⁹/L], high red blood cell transfusion intensity ≥2 units per months for 6 months; poor-risk molecular features). ^# Indicates transplant strategies (all forms of hematopoietic stem cell transplantation, see text). BM = bone marrow, CMML = chronic myelomonocytic leukemia.