Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2016, vol. 22, issue 1
Subject Area: Medicine - Hematology
Pages: 1091-1095
DOI: 10.5272/jimab.2016221.1091
Published online: 31 March 2016

J of IMAB 2016 Jan-Mar;22(1):1091-1095
Ilina Micheva1, Corresponding Autor, Trifon Chervenkov2, Canka Ruseva3, Liana Gercheva1.
1) Clinic of Hematology, Medical University, Varna, University Hospital “St. Marina“, Varna, Bulgaria
2) Laboratory of Clinical Immunology, Medical University, Varna, University Hospital “St. Marina“, Varna, Bulgaria
3) Laboratory of Medical Genetics, Medical University, Varna, University Hospital “St. Marina“, Varna, Bulgaria.

Chronic myelomonocytic leukemia (CMML) is a rare de novo myeloid neoplasm that exhibits dysplastic and proliferative features at presentation. The diagnosis is problematic with several specific controversial issues.
Aim: To analyze the cases with CMML diagnosed in the Hematology clinic, UMHAT “St. Marina”, Varna with assessment of risk, prognosis and survival.
Materials and methods: The results from cytology, flow cytometry, histology, and genetics are re-estimated. For the risk stratification the CPSS was used. The statistical analysis is performed using SPSS 19.
Results: Fifteen patients with CMML, 12 men and 3 women, with median age of 69,8 years were included in the study. According to the leukocyte count 12 were myeloproliferative (CMML/MP) and 3 myelodysplastic CMML (CMML/MD). The flow cytometry of peripheral blood and bone marrow was characterized by CD14, CD64, CD16 and CD56 expression. According to the histology of the bone marrow 2 cases were described as MDS, 1 as MDS/MPN, the rest as MPN with fibrosis in two of the cases. The cytogenetic risk was high in 5 patients and low in 10. According to CPSS one patient was with low risk, 3 with intermediate 1, 9 with intermediate 2 and 2 with high risk. Acute myeloid leukemia transformation occurred in 9 patients within median period of 13.1 months. The median survival after transformation was 2,5 months. The median survival in the whole group was 21.4 months. Conclusion: CMML is an aggressive disease. The prognosis of patients with CMML is poor, with low survival and high risk of transformation. The therapeutic options are limited.

Key words: Chronic myelomonocytic leukemia, risk stratification, survival,

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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Micheva I, Chervenkov T, Ruseva C, Gercheva L. Chronic myelomonocytic leukemia - review and clinical experience of the Hematology Department UMHAT “St. Marina” Varna. J of IMAB. 2016 Jan-Mar;22(1):1091-1095. DOI:

Correspondence to: Ilina Micheva, MD, PhD, Assoc. Prof., Department Hematology, Medical University of Varna; 1, Hristo Smirnenski str., 9010 Varna, Bulgaria; E-mail:

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Received: 15 December 2015
Published online: 31 March 2016

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