Inflammatory and Immune Manifestations in Patients with Chronic Myelomonocytic Leukemia

Assessing the therapeutic management of immune manifestations associated with chronic myelomonocytic leukemia (CMML) remains a challenging task. The first-line therapy to treat CMML is steroid drugs, however, approximately 30% of patients develop cortico-dependence to these drugs.

Researchers for this study sought evaluate the prevalence of cortico-dependent patients and determine if the presence of immune manifestations in CMML patients represents a diagnostic risk factor. The findings were published in the SOHO 2019 Meeting Proceedings Supplement in Clinical Lymphoma, Myeloma and Leukemia.

In this retrospective cohort study, which took place between January 2007 and June 2018 at an Argentinian hospital, researchers evaluated 70 patients diagnosed by World Health Organization (WHO) criteria with CMML. All study subjects were older than 18 years of age.

According to the results of the study, 44 CMML patients (62.85%) turned out to have an immune manifestation. The results showed that immune manifestations that occurred included: inflammatory arthritis 18.6% (13 cases), immune thrombocytopenic purpura 10% (7 cases), vasculitis 7.1% (5 cases), psoriasis 7.1% (5 cases). Moreover, two patients presented with erythema nodosum and rheumatoid arthritis, respectively, and one patient presented with and a patient with polyidermatomyositis, panarteritis nodosa and chronic inflammatory demyelinating polyneuropathy.

Furthermore, of the 44 patients with inflammatory and immune manifestations, 35 (80%) were administered corticoid treatment. The researchers observed that 80% (28 patients) developed cortico-dependence. In the subgroup of 13 patients with inflammatory arthritis, 12 required steroid treatment and 10 of them were cortico-dependent. The average overall survival for the complete cohort of participants was 34 months – 33 months for patients without immune manifestations and 34.2 months with these manifestations. Overall, the study found no statistically notable differences between the two groups.

“Argentinian CMML patients have similar characteristics to those reported in international literature,” the authors wrote in their conclusion.

Read more at: Castillo B, et al. Inflammatory and Immune Manifestations in Patients with Chronic Myelomonocytic Leukemia. Published for the SOHO 2019 Annual Meeting; September 11-14, 2019; Houston, TX.