Pathology
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Atlas of Bone Marrow pathology
Mojmir Moulis, Josef Feit et al.
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Chronic Myelomonocytic Leukemia (CMML)
Introduction

Clonal disease of the hematopoietic stem cell, defined by persistent monocytosis (at least 3 months).

Clinical signs

Approximately 40% of cases show a RAS gene mutation, are BRC-ABL1 negative, and the PDGFRA and PDGFRB transformations are absent.

Clinical signs
  • weight loss
  • fever
  • night sweats
  • infections
  • hemorrhage
    • monocytosis in peripheral blood more than 1×109/l
    • splenomegaly
    • BCR/ABL1 negative
    • less than 20% blasts in peripheral blood or bone marrow
    • dysplastic changes in at least one hematopoietic lineage
      • CMML-1: less than 10% blasts
      • CMML-2: 10 – 19% blasts
    • prognosis: median survival time is 20 – 40 months, 15 – 30%
      • of patients develop AML
Pictures

Chronic myelomonocytic leukemia: Chronic myelomonocytic leukemia, bone marrow, HE 100x (72740) Chronic myelomonocytic leukemia, bone marrow, PAS 100x (72737)