Risk-adjusted comparison of survival in chronic myelomonocytic leukemia with and without allogeneic stem cell transplant: Mayo Clinic experience in 775 consecutive patients
Abstract
Background: The recently published BLAST clinical risk model for chronic myelomonocytic leukemia (CMML) and its molecular version (BLAST-Mol) differentiate low, intermediate, and high risk groups (Blood 2025; blood.2024027170. doi: https://doi.org/10.1182/blood.2024027170). The objective of the current study was to examine the survival impact of allogeneic stem cell transplant (ASCT) in a consecutive series of Mayo Clinic patients with CMML, overall and adjusted for baseline BLAST/BLAST-Mol risk category.
Methods: CMML diagnosis and sub-categorization were according to the International Consensus Classification, which included CMML1 (bone marrow/peripheral blood blasts <10%/<5%) vs CMML-2 (bone marrow/peripheral blood blasts ≥10%/≥5%) and CMML-MP (leukocytes ≥13 x 10⁹/L) vs. CMML-MDS (leukocytes <13 x 10⁹/L) [Arber et al. Blood 2022;140:1200]. The BLAST score is based on clinical risk factors including circulating blasts ≥2%, leukocytes ≥13 x 10⁹/L, and severe or moderate anemia whereas BLAST-Mol also accounts for mutations and karyotype. Comparative parameters and overall survival (OS) were calculated from the time of initial CMML diagnosis for both the transplant and non-transplant groups. Statistical analyses were performed using JMP Pro 17.1.0, (SAS Institute, Cary, NC, USA).
Results: A total of 775 consecutive Mayo Clinic patients with CMML (68% males, median age 71 years) were included in the current retrospective study (1994-2024). At a median follow-up of 77 months,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 624 participants or records.
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