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oai:recercat.cat:10230/543112026-04-10T05:16:51Zcom_2072_6col_2072_452952

Outcomes and molecular profile of oligomonocytic CMML support its consideration as the first stage in the CMML continuum Calvo González, Xavier Roman-Bravo, David García Gisbert, Nieves, 1994- Rodriguez-Sevilla, Juan José García-Ávila, Sara Florensa Brichs, Lourdes Gibert Fernandez, Joan, 1988- Fernández Rodríguez, M. Concepción Salido Galeote, Marta Puiggros Metje, Anna Maria Espinet Solà, Blanca Colomo Saperas, Luis Alberto Bellosillo Paricio, Beatriz Ferrer, Ana Arenillas Rocha, Leonor Leucèmia Leucèmia mieloide atients with oligomonocytic chronic myelomonocytic leukemia (OM-CMML) are currently classified according to the 2017 World Health Organization myelodysplastic syndromes classification. However, recent data support considering OM-CMML as a specific subtype of chronic myelomonocytic leukemia (CMML), given their similar clinical, genomic, and immunophenotypic profiles. The main purpose of our study was to provide survival outcome data of a well-annotated series of 42 patients with OM-CMML and to compare them to 162 patients with CMML, 120 with dysplastic type (D-CMML), and 42 with proliferative type (P-CMML). OM-CMML had significantly longer overall survival (OS) and acute myeloid leukemia-free survival than did patients with CMML, considered as a whole group, and when compared with D-CMML and P-CMML. Moreover, gene mutations associated with increased proliferation (ie, ASXL1 and RAS-pathway mutations) were identified as independent adverse prognostic factors for OS in our series. We found that at a median follow-up of 53.47 months, 29.3% of our patients with OM-CMML progressed to D-CMML, and at a median follow-up of 46.03 months, 28.6% of our D-CMML group progressed to P-CMML. These data support the existence of an evolutionary continuum of OM-CMML, D-CMML, and P-CMML. In this context, we observed that harboring more than 3 mutated genes, carrying ASXL1 mutations, and a peripheral blood monocyte percentage >20% significantly predicted a shorter time of progression of OM-CMML into overt CMML. These variables were also detected as independent adverse prognostic factors for OS in OM-CMML. These data support the consideration of OM-CMML as the first evolutionary stage within the proliferative continuum of CMML. 2022-10-07T06:28:17Z 2022-10-07T06:28:17Z 2022 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Calvo X, Roman-Bravo D, Garcia-Gisbert N, Rodriguez-Sevilla JJ, Garcia-Avila S, Florensa L, et al. Outcomes and molecular profile of oligomonocytic CMML support its consideration as the first stage in the CMML continuum. Blood Adv. 2022 Jul 12; 6(13): 3921-31. DOI: 10.1182/bloodadvances.2022007359 2473-9529 http://hdl.handle.net/10230/54311 http://dx.doi.org/10.1182/bloodadvances.2022007359 eng Copyright © 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode, permitting only noncommercial, nonderivative use with attribution. All other rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode info:eu-repo/semantics/openAccess application/pdf application/pdf American Society of Hematology