MDS-229: Assessment of Baseline Clinical and Molecular Characteristics in Indolent Chronic Myelomonocytic Leukemia

Context: Chronic myelomonocytic leukemia (CMML) is characterized by marked clinical heterogeneity. Generally associated with poor outcomes, median overall survival (mOS) is 3 years. Multiple prognostic models consider cardinal clinical, cytogenetic, and molecular features as critical for estimating individual risk and outlining treatment. Identification and longitudinal assessment of features of interest have become important for predicting which patients tend to have a more indolent course compared to those who will progress. Objective: To identify patients with more indolent CMML and analyze disease features at the time of diagnosis. Design: Retrospective cohort of patients with CMML treated at Moffitt between 1995–2020. Patient Population: 729 patients with CMML. Interventions: Data were collected retrospectively. Patients were stratified into 2 cohorts: those remaining in observation for >3 years versus those who required treatment Main Outcome Measures: Correlation between baseline characteristics and treatment initiation within 3 years, OS. Results: Out of 729 patients, 68.3% were male (498), and 88.5% were Caucasian (645). Median age at diagnosis was 71 (17–95) years. A total of 123 patients (17%) did not require treatment within 3 years of diagnosis. mOS was 70 mo among those who did not require early treatment, compared to 25 mo for those who did (p Conclusions: A small subset of CMML patients (17%) have a more indolent disease course. Clinical and molecular features at diagnosis can be assessed to identify them. Next, we aim to identify changes in clinical and molecular features from baseline immediately anteceding the need for treatment to establish whether they predict disease evolution.