Elena et al modified the CPSS of Such et al by expanding the genetic risk assessment of chronic myelomonocytic leukemia (CMML). The authors are from multiple institutions in Spain and Germany.
Patient selection: chronic myelomonocytic leukemia (CMML)
Parameters:
(1) percent bone marrow blasts (previously WHO subtype CMML-1 or CMML-2)
(2) FAB subtype of CMML based on the WBC count (myelodysplastic or myeloproliferative)
(3) genetic risk group of Elena et al
(4) RBC transfusion dependency (>= 1 RBC transfusion every 8 weeks for > 4 months)
Findings
CMML-1
CMML-2
blasts and promyelocytes in peripheral blood
< 5%
5-19%
blasts and promyelocytes in bone marrow
< 10%
10-19%
Auer rods
none
any (irrespective of blast count)
where:
• Blast and promyelocyte counts >= 20% indicate acute leukemia.
Parameter
Finding
Points
percent bone marrow blasts
0
>= 5%
1
FAB subtype
CMML-MD (WBC count < 13 * 10^9/L)
CMML-MP (WBC count >= 13 * 10^9/L)
cytogenetic risk
low
intermediate-1
intermediate-2
2
high
3
RBC transfusion dependency
no
yes
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
Score
Risk Group
Median Overall Survival
> 144 months
64 months
2 or 3
37 months
>=4
18 months
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Specialty: Hematology Oncology
