{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:42:21Z","timestamp":1792514541335,"version":"4.5.0"},"reference-count":14,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Haematol"],"abstract":"<jats:p>Introduction: The prognostic impact of therapy-related chronic myelomonocytic leukemia (t-CMML) compared with de novo CMML (dnCMML) remains uncertain, in part due to the absence of therapy-related designations in cancer registries. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we compared outcomes between dnCMML and t-CMML, operationally defined by antecedent chemotherapy and\/or radiotherapy and diagnosis as a subsequent primary malignancy. Survival was evaluated by antecedent treatment exposure and within major antecedent malignancy groups. Additional operational definitions of t-CMML were evaluated to assess the robustness of findings. Results: Among 8,432 patients diagnosed with CMML between 2000 and 2022 after exclusion of antecedent myeloid malignancies, 594 (7.0%) met criteria for the primary definition of t-CMML. Median overall survival (OS) for the entire CMML cohort was 18 months, with shorter median OS observed for t-CMML compared with dnCMML (14 vs. 19 months). On multivariable Cox regression adjusted for age, sex, race, and era of diagnosis, t-CMML was associated with an increased risk of death (hazard ratio 1.20, 95% CI 1.09\u20131.32). Compared with dnCMML, inferior OS was observed among patients with recorded chemotherapy exposure but not among those treated with radiotherapy alone. Direct comparisons between chemotherapy-exposed and radiotherapy-only patients showed no significant difference in OS in the pooled adjusted analysis or within individual antecedent malignancy groups. Increasing definitional stringency was associated with stepwise worsening OS. Conclusion: Registry-defined t-CMML was associated with inferior survival compared with de novo disease. Although chemotherapy-exposed t-CMML was associated with poorer outcomes relative to dnCMML, OS did not differ significantly between chemotherapy-exposed and radiotherapy-only patients in direct pooled or malignancy-specific comparisons. Studies integrating detailed treatment histories with molecular and cytogenetic data are needed to clarify the biology and prognostic significance of t-CMML.<\/jats:p>","DOI":"10.1159\/aha\/abkag010","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T13:54:28Z","timestamp":1788616468000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Inferior Survival in Therapy-Related Chronic Myelomonocytic Leukemia: A Population-Based Analysis"],"prefix":"10.1159","author":[{"given":"Arjun","family":"Syal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Tremblay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24939"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024012565"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2015.06.002"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-03-491399"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000293"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2022.281233"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35214"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/s2152-2650(25)01785-9"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2025017435"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1038\/nrc.2017.60"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2018.04.018"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-023-01864-6"}],"container-title":["Acta Haematologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/aha\/abkag010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:01:05Z","timestamp":1792512065000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/aha\/abkag010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":14,"URL":"https:\/\/doi.org\/10.1159\/aha\/abkag010","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33436267","asserted-by":"subject"}]},"ISSN":["0001-5792","1421-9662"],"issn-type":[{"value":"0001-5792","type":"print"},{"value":"1421-9662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]}}}