{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T17:11:26Z","timestamp":1791133886015,"version":"4.1.0"},"reference-count":74,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T00:00:00Z","timestamp":1382572800000},"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":[[2013,11]]},"abstract":"<jats:sec><jats:title>Disease overview<\/jats:title><jats:p>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\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L) in the peripheral blood that persists for at least 3 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Diagnosis<\/jats:title><jats:p>The diagnosis of CMML rests on a combination of morphologic, histopathologic and chromosomal abnormalities in the bone marrow. It is important to exclude other myeloproliferative neoplasms and infectious\/autoimmune conditions that can cause monocytosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Risk stratification<\/jats:title><jats:p>Several CMML\u2010specific prognostic models incorporating novel mutations have been recently reported. The Mayo prognostic model classified CMML patients into three risk groups based on: increased absolute monocyte count, presence of circulating blasts, hemoglobin &lt;10 gm\/dL and platelets &lt;100\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L. The median survival was 32 months, 18.5 months and 10 months in the low, intermediate, and high\u2010risk groups, respectively. The Groupe Francophone des (GFM) score segregated CMML patients into three risk groups based on: age &gt;65 years, WBC &gt;15\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L, anemia, platelets &lt;100\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L, and <jats:italic>ASXL1<\/jats:italic> mutation status. After a median follow\u2010up of 2.5 years, survival ranged from not reached in the low\u2010risk group to 14.4 months in the high\u2010risk group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Risk\u2010adapted therapy<\/jats:title><jats:p>The Food and Drug Administration has approved azacitidine and decitabine for the treatment of patients with CMML. An allogeneic stem cell transplant can potentially offer a curative option to a subset of CMML patients. It is hoped that with the discovery of several novel mutations, targeted therapies will become available in the near future. Am. J. 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