Grignano E, Mekinian A, Braun T, Liozon E, Hamidou M, Decaux O, Puéchal X, Kahn JE, Schoindre Y, Rossignol J, Lortholary O, Lioger B, Hermine O, Park S, Ades L, Montestruc F, Ricard L, Gardin C, Fenaux P, Fain O; GFM, SNFMI and CRI.
Autoimmune and inflammatory diseases associated with chronic myelomonocytic leukemia: A series of 26 cases and literature review.
Leuk Res. 2016 Aug;47:136-41. doi: 10.1016/j.leukres.2016.05.013. Epub 2016 Jun 2.
We wanted to describe the characteristics, treatment and outcome of autoimmune and inflammatory diseases (SAIDs) associated with chronic myelomonocytic leukemia (CMML), and conducted a French multicenter retrospective study and a literature review. We included 26 cases of CMML (median age 75 years, 54% female), 80% with CMML-1. CPSS score was low (0 or 1) in 75% of cases. SAIDS was systemic vasculitis in 54%. Diagnosis of the 2 diseases was concomitant in 31% cases, and CMML was diagnosed before SAIDs in 12 cases (46%). First line treatment for SAIDs consisted mostly of steroid, with 85% of response. Second-line treatment was needed in 40% cases. Six patients received hypomethylating agents, with 66% response on SAIDs. A literature review found 49 cases of CMML-associated SAIDs, in whom SAIDs was systemic vasculitis in 29% cases. Hence, vasculitis is the most frequent SAIDs associated with CMML. After initial response to steroids, recurrence and steroid-dependence were frequent. Hypomethylating agents may be interesting in this context.