{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:55:43Z","timestamp":1791172543049,"version":"4.1.0"},"reference-count":77,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,5,21]],"date-time":"2012-05-21T00:00:00Z","timestamp":1337558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Disease Overview:<\/jats:italic> Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic stem cell disorder that is classified as a myelodysplastic\/myeloproliferative neoplasm by the 2008 World Health Organization classification of hematopoietic tumors. It is characterized by absolute monocytosis (&gt;1 \u00d7 10<jats:sup>9<\/jats:sup> L<jats:sup>\u22121<\/jats:sup>) in the peripheral blood that persists for at least 3 months. Patients may present with symptoms related to cytopenias and\/or an underlying hypercatabolic state with drenching night sweats, splenomegaly, and weight loss.<\/jats:p><jats:p><jats:italic>Diagnosis:<\/jats:italic> The diagnosis of CMML rests on a combination of morphologic, histopathologic, and chromosomal abnormalities in the bone marrow, after careful exclusion of other conditions (both malignant and nonmalignant) that can cause monocytosis. Numerous molecular abnormalities have been recently recognized in patients with CMML\u2014unfortunately, no single pathognomonic finding specific to CMML has been identified thus far.<\/jats:p><jats:p><jats:italic>Risk stratification:<\/jats:italic> The International Prognostic Scoring System for myelodysplastic syndrome (MDS) cannot be used to risk stratify patients with CMML because this model excluded patients with a leukocyte count &gt;12 \u00d7 10<jats:sup>9<\/jats:sup> L<jats:sup>\u22121<\/jats:sup>. Other risk stratification models such as the MD Anderson prognostic score and Dusseldorf score have been published. In the only model that took karyotype into account, bone marrow blasts \u2265 10%, leukocyte count \u2265 13 \u00d7 10<jats:sup>9<\/jats:sup> L<jats:sup>\u22121<\/jats:sup>, hemoglobin &lt; 10 g\/dL, platelet count &lt; 100 \u00d7 10<jats:sup>9<\/jats:sup> L<jats:sup>\u22121<\/jats:sup>, and presence of trisomy 8, abnormalities of chromosome 7, or complex karyotype were found to be independent predictors of adverse survival.<\/jats:p><jats:p><jats:italic>Risk\u2010adapted therapy:<\/jats:italic> The Food and Drug Administration has approved azacitidine and decitabine for the treatment of patients with CMML based on two pivotal trials in MDS. Novel classes of agents including immunomodulatory drugs, nucleoside analogs, and small\u2010molecule tyrosine kinase inhibitors are being investigated in the treatment of CMML. With the advent of reduced intensity conditioning, an allogeneic stem cell transplant has also become a viable option for a subset of patients. Am. J. Hematol. 87:610\u2013619, 2012. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23203","type":"journal-article","created":{"date-parts":[[2012,5,21]],"date-time":"2012-05-21T12:41:35Z","timestamp":1337604095000},"page":"610-619","source":"Crossref","is-referenced-by-count":41,"title":["Chronic myelomonocytic leukemia: 2012 update on diagnosis, risk stratification, and management"],"prefix":"10.1002","volume":"87","author":[{"given":"Sameer 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