An Assessment of the Three Popular Prognostic Scoring Systems for Chronic Myelomonocytic Leukemia (CMML) in an Indian Context

A. Saha, Sneha Kakoty, Kazoomi Patel, V. Rai, Jyoti Sawhney, Nainesh Menat
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Abstract

Abstract Introduction:  Chronic myelomonocytic leukemia (CMML) is a rare clonal hematopoietic neoplasm with a prevalence of 1.05 to 1.94 cases per 1,00,000 population. There are multiple prognostic scoring system used in practice for CMML, which include both cytogenetic and next-generation sequencing based. Objective  This study assesses the clinicohematological profile of CMML patients, along with comparison of three widely used prognostic scoring systems for CMML (CMML-specific prognostic scoring system, MD Anderson prognostic score, Mayo prognostic model). Materials and Methods : This study is an 8-year retrospective study. All relevant data had been retrieved and reviewed by the authors. Inclusion and exclusion criteria: All the cases that were diagnosed before 2016 as per 2008 criteria were reclassified, (2) all the cases that were positive for the mutations associated with myeloproliferative neoplasms were excluded, and (3) cases with more than or equal to 20% blast/blast equivalents were excluded. A univariate analysis was done followed by a multivariate analysis for all the parameters constituting each scoring system. Lastly, a receiver operating characteristic curve was plotted for all the three scoring systems. Result : There were total 23 patients, with a median age of 63 years and a male to female ratio of 2.3:1. Cytogenetic aberration and genetic mutation were observed in 6 and 3 cases, respectively. The median overall survival (OS) was 48 months and the median leukemia-free survival was 12 months. Post-multivariate analysis, the parameters with significant impact on OS were absolute monocyte count more than 10 × 10^9/L, myeloid precursors in peripheral blood, hemoglobin less than 10g/dL, platelet less than 100 × 10^9/L, hemoglobin less than 12g/dL, and absolute lymphocyte count more than 2.5 × 10^9/L. Conclusion : To summarize, we discovered CPSS to be a better prognostic tool for a setup like ours, since molecular investigations are not always readily available for each case. More such researches are needed in the near future so that we can design better prognostic tools and see for their usefulness in real life.
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印度慢性粒细胞白血病(CMML)的三种流行预后评分系统的评估
摘要简介:慢性髓细胞白血病(Chronic myelmonocytic leukemia, CMML)是一种罕见的克隆性造血肿瘤,发病率为每10万人1.05 ~ 1.94例。在CMML的实践中,有多种预后评分系统,包括细胞遗传学和下一代测序。目的本研究评估CMML患者的临床血液学特征,并比较三种广泛使用的CMML预后评分系统(CMML特异性预后评分系统、MD Anderson预后评分系统、Mayo预后模型)。材料与方法:本研究为8年回顾性研究。所有相关数据已由作者检索和审阅。纳入和排除标准:所有2016年以前按照2008年标准诊断的病例重新分类,(2)排除所有骨髓增生性肿瘤相关突变阳性的病例,(3)排除≥20% blast/blast当量的病例。先进行单因素分析,然后对构成每个评分系统的所有参数进行多因素分析。最后,绘制了三种评分系统的受者工作特征曲线。结果:共23例患者,中位年龄63岁,男女比例为2.3:1。细胞遗传学畸变6例,基因突变3例。中位总生存期(OS)为48个月,中位无白血病生存期为12个月。多因素分析后,对OS有显著影响的参数为单核细胞绝对计数大于10 × 10^9/L、外周血髓系前体、血红蛋白小于10g/dL、血小板小于100 × 10^9/L、血红蛋白小于12g/dL、淋巴细胞绝对计数大于2.5 × 10^9/L。结论:总而言之,我们发现CPSS是一种更好的预测工具,因为分子调查并不总是容易用于每个病例。在不久的将来,我们需要更多这样的研究,这样我们才能设计出更好的预测工具,并看看它们在现实生活中的用处。
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来源期刊
CiteScore
0.40
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0.00%
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91
期刊介绍: The journal will cover technical and clinical studies related to medical and pediatric oncology in human well being including ethical and social issues. Articles with clinical interest and implications will be given preference.
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