Comparison of three prognostic scoring systems in a series of 146 cases of chronic myelomonocytic leukemia (CMML): MD Anderson prognostic score (MDAPS), CMML-specific prognostic scoring system (CPSS) and Mayo prognostic model. A detailed review of prognostic factors in CMML.
Although specific prognostic models for chronic myelomonocytic leukemia (CMML) exist, few are based on large series of patients. MD Anderson prognostic score (MDAPS) has been the most useful for CMML risk assessment. Due to recent emergence of CMML-specific prognostic scoring system (CPSS) and Mayo prognostic model, we compared the three scores. One hundred forty-six CMML patients diagnosed between 1998 and 2014 were retrospectively analyzed. Univariate analysis was performed to assess prognostic impact on overall survival (OS) and leukemia-free survival (LFS) of the variables composing the scores and all items showed prognostic value on OS with the exception of the presence of circulating immature myeloid cells. Regarding LFS, only CPSS variables, bone marrow blast ≥10% and an absolute monocyte count >10×109/L had an impact. When the scores were applied, all showed an impact on OS and retained their significance in multivariate analysis. By using ROC curves and C-index, CPSS showed a slightly better predictive value for mortality and leukemia transformation. Variables composing the three indexes were compared in multivariate analysis and only CPSS parameters and platelets<100×109/L retained their significance. Based on these findings, by adding platelet count to CPSS, a new score was implemented (CPSS-P) showing the best risk prediction capability in our series. This study reinforces the validity of the tested scores.
Hematopathology Unit, Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Josep Carreras Leukaemia Research Institute, Barcelona, Spain. Electronic address: xcalvo@clinic.ub.es.
Xavier
X
Calvo
Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain; Josep Carreras Leukaemia Research Institute, Barcelona, Spain.
Meritxell
M
Nomdedeu
Department of Hemotherapy and Hemostasis, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
Rodrigo
R
Santacruz
Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
Núria
N
Martínez
Hematopathology Unit, Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Dolors
D
Costa
Department of Hemotherapy and Hemostasis, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
Arturo
A
Pereira
Josep Carreras Leukaemia Research Institute, Barcelona, Spain; Hematology Department, ICO-Germans Trias i Pujol Hospital, Universitat Autònoma de Barcelona, Badalona,Spain.
Natalia
N
Estrada
Josep Carreras Leukaemia Research Institute, Barcelona, Spain; Hematology Department, ICO-Germans Trias i Pujol Hospital, Universitat Autònoma de Barcelona, Badalona,Spain.
Blanca
B
Xicoy
Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain; Josep Carreras Leukaemia Research Institute, Barcelona, Spain.
Jordi
J
Esteve
Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain; Josep Carreras Leukaemia Research Institute, Barcelona, Spain. Electronic address: nomdedeu@clinic.ub.es.
Benet
B
Nomdedeu
CMML; CPSS; MDAPS; Mayo prognostic model; Prognostic factors