Chronic myelomonocytic leukemia: Forefront of the field in 2015

Benton, Christopher B.; Nazha, Aziz; Pemmaraju, Naveen

doi:10.1016/j.critrevonc.2015.03.002

Cited by 26 publications

(33 citation statements)

References 171 publications

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“…In the CMML group, the median proportion of monocytes was 24% (4.2x10 9 /l), which was the highest among the three subtypes and the median proportion of blasts and neutrophil precursors were 0.6% and 3%, respectively. This is similar to proportions observed within this group in previous studies (7)(8)(9)(10). Therefore, all results indicate the percentage of monocytes in CMML patients is >10%, the percentage of blasts is <5% and neutrophil precursors make up <10% in peripheral blood.…”

Section: Discussionsupporting

confidence: 74%

Routine blood examinations combined with morphological analysis for the diagnosis of myelodysplastic/myeloproliferative neoplasms

Sun

Zhang

et al. 2016

Oncology Letters

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Abstract. In 2008, the World Health Organization (WHO) introduced a new hematological neoplasm category; myelodysplastic/myeloproliferative neoplasms (MDS/MPN), which included four main subcategories. This disease is often misdiagnosed, which delays effective therapy. The present study evaluated the role of routine blood examinations and morphological analysis of peripheral blood cells in the reliable diagnosis of MDS/MPN. In total, 236 adult MDS/MPN patients were analyzed. The analysis included 10 routine blood parameters measured using a Sysmex XE-2100™, 3 differential percentage parameters and 7 morphological features of peripheral blood cells which were analyzed by optical microscopy, and 3 differential absolute count numbers obtained based on the corresponding differential percentages and absolute count of blood cells. The parameters were compared among the subcategories and a value of P<0.05 was considered to indicate a statistically significant difference. The median white blood cell and hemoglobin counts of the patients were 18.0x10 9 /l and 88 g/l, respectively. The proportion of monocytes increased to 8% (1.82x10 9 /l), the proportion of blast cells increased to 1% (0.5x10 9 /l) and that of neutrophil precursors increased to 10% (1.98x10 9 /l). A total of 87% of all patients presented with hypogranulation and 71% presented with abnormal condensed nuclear chromatin in granulocytes. Atypical monocytes were observed in 73% of all patients and Pseudo-Pelger cells were observed in 60%. Significant differences were detected among the subcategories. The present study demonstrated that combining blood routine parameters and the morphological analysis of peripheral blood cells have an essential role in the reliable diagnosis of MDS/MPN based on WHO categories.

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Section: Discussionsupporting

confidence: 74%

Routine blood examinations combined with morphological analysis for the diagnosis of myelodysplastic/myeloproliferative neoplasms

Sun

Zhang

et al. 2016

Oncology Letters

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“…Acute myeloid leukemia (AML) and chronic myelomonocytic leukemia (CMML) represent two different subtypes of the so called myeloid neoplasms . This type of cancer is usually dominated by the rapid growth of abnormal immature white blood cell precursors that accumulate in bone marrow and peripheral blood interfering with the normal hematopoietic function . Both AML and CMML are characterized by circulating monocytic neoplastic cells.…”

Section: Figurementioning

confidence: 99%

Few‐Layer Graphene Kills Selectively Tumor Cells from Myelomonocytic Leukemia Patients

et al. 2017

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In the cure of cancer, a major cause of today's mortality, chemotherapy is the most common treatment, though serious frequent challenges are encountered by current anticancer drugs. We discovered that few‐layer graphene (FLG) dispersions have a specific killer action on monocytes, showing neither toxic nor activation effects on other immune cells. We confirmed the therapeutic application of graphene on an aggressive type of cancer that is myelomonocytic leukemia, where the monocytes are in their malignant form. We demonstrated that graphene has the unique ability to target and boost specifically the necrosis of monocytic cancer cells. Moreover, the comparison between FLG and a common chemotherapeutic drug, etoposide, confirmed the higher specificity and toxicity of FLG. Since current chemotherapy treatments of leukemia still cause serious problems, these findings open the way to new and safer therapeutic approaches.

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“…Cytogenetic evidence of clonality is found in only 20% to 40% of CMML cases. (4,5) The morphological differentiation between reactive monocytosis and CMML can be challenging, especially in cases with absent or minimal dysplasia and a normal karyotype. Flow cytometry immunophenotyping is a reliable method for quantitative and qualitative evaluation of hematopoietic cells and plays an increasingly important role in the diagnosis of myelodysplastic syndrome (MDS).…”

mentioning

confidence: 99%

Application of immunophenotypic analysis in distinguishing chronic myelomonocytic leukemia from reactive monocytosis

Feng

Bhatt

et al. 2018

Cytometry Part B Clinical

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Objectives The purpose of this study was to determine whether immunophenotypic profiles detected by flow cytometry are useful in differentiating chronic myelomonocytic leukemia (CMML) from reactive monocytosis, and between CMML subtypes. Methods Eight‐color flow cytometry was used to immunophenotype blasts, monocytes, and granulocytes in the bone marrow of 34 patients with CMML and 12 patients with reactive monocytosis. Results Bone marrow myeloblast, promonocyte, and monocyte counts by flow cytometry were significantly higher in the CMML group than in the reactive monocytosis group. Myeloblast aberrancies were present in all CMML patients as compared with 2 of 12 (16.7%) reactive monocytosis patients (P < 0.001). The number of blast aberrancies ranged from one to nine (median, four) in CMML patients and 94.1% of CMML cases exhibited ≥ two aberrancies. In contrast, two reactive monocytosis cases showed only one phenotypic abnormality of blasts. Monocyte and granulocyte aberrancies were present in 26 of 34 (76.5%) and in 31 of 34 (91.2%) CMML patients, respectively. Decreased side scatter (SSC) and abnormal CD11b/CD13/CD16 maturation pattern in granulocytes were more frequent in CMML than in reactive monocytosis. No significant differences in antigen expression were detected between the CMML subtypes except that altered CD45/SSC pattern on the blasts was more commonly observed in CMML‐0/1 than in CMML‐2. Conclusions CMML has phenotypic aberrancies in monocytes, granulocytes, and more frequently in myeloblasts. Aberrant expression of two or more antigens in myeloblasts by flow cytometry has a high sensitivity (94.1%) and a high specificity (100%) to differentiate CMML from reactive monocytosis. © 2018 International Clinical Cytometry Society

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Chronic myelomonocytic leukemia: Forefront of the field in 2015

Cited by 26 publications

References 171 publications

Routine blood examinations combined with morphological analysis for the diagnosis of myelodysplastic/myeloproliferative neoplasms

Routine blood examinations combined with morphological analysis for the diagnosis of myelodysplastic/myeloproliferative neoplasms

Few‐Layer Graphene Kills Selectively Tumor Cells from Myelomonocytic Leukemia Patients

Application of immunophenotypic analysis in distinguishing chronic myelomonocytic leukemia from reactive monocytosis

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