Chronic myelomonocytic leukemia (CMML) is a condition where the body produces too many immature white blood cells, causing problems such as anemia, infection, and bleeding. It is more common in older males and can be caused by environmental factors, chemicals, radiation, and certain anticancer drugs. There are two types of CMML, which are distinguished by the percentage of blasts present in the bone marrow and blood. Treatment options include drugs and stem cell transplantation, but the condition is usually not curable. Survival rates depend on various factors such as the number of blasts, anemia, and white blood cell count. In some cases, CMML can develop into acute myeloid leukemia (AML).
Chronic myelomonocytic leukemia (CMML) is a condition in which the body creates too many immature white blood cells, known as myeloblasts and myelocytes. These cells prevent the formation of monocytes, which fight infection and help other blood cells in the body build immunity. The extra cells also wreak havoc in the body by taking up needed space in the bone marrow for platelets and red blood cells. As a result, a patient may suffer from several problems including anemia, infection, or a tendency to bleed easily.
The condition is more common among older males. It is most commonly caused by environmental elements, chemicals and radiation exposure. Some cases of chronic myelomonocytic leukemia are also attributed to the use of certain types of anticancer drugs. The severity of the condition depends on the number of immature cells while blood cells, or blasts, are found in the bone marrow or blood; chromosomal changes; how many platelets or white blood cells are in the bone marrow and blood; and if the patient has anemia.
There are two main types of chronic myelomonocytic leukemia, which are distinguished by the percentage of blasts in the bone marrow and blood, type CMML-1 and CMML-2. The CMML-1 type indicates that there are less than 10% blasts present in the bone marrow and 2% in the blood. The CMML-10 type typically has a range of 19 to 19% bone marrow blasts and 19 to 19% blood blasts.
Symptoms of chronic myelomonocytic leukemia include anemia, a feeling of fullness under the ribs, and an enlarged spleen or liver. Some patients may develop leukopenia, an infection caused by a low white blood cell count. Other signs of CMML include bruising and bleeding caused by too few platelets and pinpoints of blood from the skin known as petechiae.
Chronic myelomonocytic leukemia is usually not curable. It can be treated with drugs such as cytabine, decitabine and imatinib, depending on the nature of the condition. If a suitable donor can be found, stem cell transplantation can sometimes cure CLML, particularly in young patients.
The average patient diagnosed with chronic myelomonocytic leukemia is expected to live one to two years after starting treatment. Certain factors work against the patient’s survival rate, including a large spleen, severe anemia, and a high lactate dehydrogenase (LDH) level. Survival is also less likely for patients who have a high number of blasts or who have an abnormally high white blood cell count overall. In some patients who have not recovered, acute myeloid leukemia can develop into acute myeloid leukemia (AML).
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