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Chronic myelomonocytic leukemia according to FAB classification: analysis
of 35 cases
P Solal-Celigny, B Desaint, A Herrera, C Chastang, M Amar, M Vroclans, N Brousse, F Mancilla, M Renoux and JF Bernard
Thirty-five patients who fulfilled the FAB diagnosis criteria of chronic
myelomonocytic leukemia (CMML), i.e., myelodysplastic features, monocytosis
over 10(9)/liter, bone marrow monocyte infiltration, blast cells less than
5% in the peripheral blood and less than 30% in the bone marrow, are
analyzed. CMML appears as an entity distinct from myelodysplastic and
myeloproliferative disorders. Splenomegaly, anemia, thrombocytopenia,
leukocytosis with monocytes and granulocytic cells in all stages of
development, increased blood and urine lysozyme levels without renal
failure, and polyclonal hyperimmunoglobulinemia are its main clinical and
biologic features. With conventional cytotoxic drugs (6-mercaptopurine,
hydroxyurea), the prognosis of CMML appears poor (median survival 475
days). None of the clinical hematologic or biologic parameters tested had a
significant effect on prognosis. As other chemotherapy trials seemed
necessary, we recently administered small doses of cytosine-arabinoside
(ARA-C) to six patients over several consecutive days and obtained a
complete remission in four. These preliminary results must be confirmed by
larger series using the diagnostic criteria proposed by the FAB cooperative
group.
Volume 63,
Issue 3,
pp. 634-638,
03/01/1984
Copyright © 1984 by The American Society of Hematology
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