A Case of Atypical Delayed a Chronic Myelomonocytic Leukemia (CMML)

Hypomethylating drugs are useful and have been approved for the treatment of myelodysplastic syndromes (MDS) and Chronic Myelomonocytic Leukemia (CMML). However, phase 2 and 3 studies that assessed these agents in MDS, have included o patients with CMML, and there are just a few specific reports on CMML patients. is actually authorised for the treatment of CMML patients with 10 myeloproliferative disorder, who are not eligible for haematopoietic stem cell transplantation. This hypomethylating agent in MDS is known for causing transient cytopenias, most often occurring during the first 2 cycles. Here we report a case of an atypical delayed and prol toxicity during Azacitidine treatment in a CMML patient; furthermore we also reviewed the literature regarding the efficacy of the drug and the management of hematologic adverse effects, in term of dose adjustments or alternative schedule Introduction. CMML is a clonal disorder of haematopoietic stem cell, often occurring in elderly patients, sharing heterogeneous clinical and morphological features of both MDS and chronic myeloproliferative disorders (MPD). Originally it was classified by the French-American working group as a myelodysplastic syndrome characterized by monocytosis (> 1000/microl), bone marrow (BM) monocyte infiltration, blast cells less than 5% in the peripheral blood (PB) and less than 30% in the BM. CMML has been reclassified and it is currently included in the Myelodysplastic/Myeloproliferative Neoplasms www.mjhid.org ISSN 2035-3006 nd Prolonged Hematologic Toxicity With Azacitidine and Review of Literature and Enrico Maria Pogliani – Università degli studi Milano Bicocca, Monza, Italia – Università degli studi Milano Monza, Italia. Phone: +390392339859; Fax: +390392333440 at no competing interests exist. 2, 4(1): e2012017, DOI: 10.4084/MJHID.2012.017 Creative Commons Attribution License ), which permits unrestricted use, distribution, and reproduction in any medium,