Impact of age on the cumulative risk of transformation in patients with chronic myelomonocytic leukaemia

Scientific paper - Original scientific paper

• Author: Sigrid Machherndl‐Spandl
• Author: Eva Jäger
• Author: Agnes Barna
• Author: Michael Gurbisz
• Author: Renate Marschon
• Author: Temeida Graf
• Author: Elmir Graf
• Author: Christoph Geissler
• Author: Gregor Hoermann
• Author: Thomas Nösslinger
• Author: Michael Pfeilstöcker
• Author: Peter Bettelheim
• Author: Otto Zach
• Author: Ansgar Weltermann
• Author: Sonja Heibl
• Author: Josef Thaler
• Author: Armin Zebisch
• Author: Heinz Sill
• Author: Reinhard Stauder
• Author: Gerald Webersinke
• Author: Rajko Kušec
• Author: Ernst Ulsperger
• Author: Bruno Schneeweiss
• Author: Leopold Öhler
• Author: Ulrich Germing
• Author: Peter Valent
• Author: Heinz Tüchler
• Author: Klaus Geissler
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

In older patients with chronic myelomonocytic leukaemia (CMML) and limited life expectancy due to age and or comorbidities, it is particularly important to consider the risk of transformation for individualised treatment decisions. There is limited information on potential differences between younger and older CMML patients regarding the cumulative risk of transformation as well as haematological, molecular and biologic characteristics. We analysed data from the Austrian Biodatabase for CMML (ABCMML) to compare these parameters in 518 CMML patients. Categorisation of patients into 3 age-related groups: <60 years, 60-79 years and ≥80 years, showed a significantly lower risk of transformation at higher age by competing risk analysis, with a 4-year risk of 39%, 23% and 13%, respectively (P < .0001). The lower probability of transformation was associated with a lower percentage of blast cells in the peripheral blood (PB) of older patients. Furthermore, we provide a simple score based on age, PB blasts and platelet counts that allowed us to define subgroups of CMML patients with a different cumulative transformation risk, including a low-risk group with a transformation risk of only 5%. Our findings may facilitate reasonable treatment decisions in elderly patients with CMML.

• Keywords (english): Adult; Age Factors; Aged; Aged, 80 and over; Biomarkers, Tumor; Comorbidity; Disease Progression; Disease Susceptibility; Female; Health Impact Assessment*; Humans; Leukemia, Myelomonocytic, Chronic / epidemiology*; Leukemia, Myelomonocytic, Chronic / etiology; Leukemia, Myelomonocytic, Chronic / mortality; Leukemia, Myelomonocytic, Chronic / pathology*; Male; Middle Aged; Odds Ratio; Prognosis
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: European Journal of Haematology
• Numbering: vol. 107, no. 2, pp. 265-274
• p-ISSN: 0902-4441
• e-ISSN: 1600-0609
• DOI: https://doi.org/10.1111/ejh.13647
• URN:NBN: urn:nbn:hr:105:108756
• Publication: 2021-08
• Document URL: https://onlinelibrary.wiley.com/doi/10.1111/ejh.13647
• Type of resource: Text
• Access conditions: Open access
• Created on: 2022-01-10 10:33:05