title: Prognostic significance of monocytosis in patients with myeloproliferative disorders.
abstract: Based on clinical and pathological findings, chronic myelomonocytic leukemia (CMML) differs from other myeloproliferative/myelodysplastic disorders by its hallmark, monocytosis. It is unknown whether the presence of monocytosis and the diagnosis of CMML carry a prognostic significance. The present study aimed to determine whether the survival of patients with CMML differs from that of patients with BCR/ABL-negative CML or Ph(1-), BCR/ABL-unknown CML, once other potentially prognostic variables have been accounted for. The records of 485 patients with myeloproliferative/myelodysplastic disorders [CMML, n = 304; BCR/ABL-negative CML, n = 107; Ph(1-), BCR/ABL unknown, n = 74] were analysed. Of the covariates found to be significantly (P < 0.01) associated with survival in univariate and multivariate analyses, the following remained predictive and adversely associated with survival, after accounting for the influence of other covariates: increasing age, white blood cell count, platelets, bone marrow blasts and cellularity, decreasing hemoglobin, abnormal karyotype, and diagnosis of CMML. The diagnosis of CMML is prognostically significant and independently associated with a shorter survival and a higher risk of death than BCR/ABL-negative CML or Ph(1-) BCR/ABL-unknown CML.
authors.affiliation: Departments of Leukemia, UT MD Anderson Cancer Center, PO Box 301402, Houston, TX 77230, USA. mberan@mdanderson.org
authors.forename: Miloslav
authors.initials: M
authors.lastname: Beran
authors.forename: Yu
authors.initials: Y
authors.lastname: Shen
authors.forename: Francesco
authors.initials: F
authors.lastname: Onida
authors.forename: Sijin
authors.initials: S
authors.lastname: Wen
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Elihu
authors.initials: E
authors.lastname: Estey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D016313:Genes, abl; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D015477:Leukemia, Myelomonocytic, Chronic / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D007958:Leukocyte Count; D007964:Leukocytosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D009196:Myeloproliferative Disorders / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D010677:Philadelphia Chromosome; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate