Publication Date:
2016-12-02
Description:
Background: The WHO requires a sustained peripheral monocytosis (≥1x109cells/L) for the diagnosis of CMML. However, a peripheral monocytosis is not pathognomonic because monocytosis is observed in other hematologic neoplasms and benign reactive conditions. A recent study demonstrated that CMML is uniquely represented by the expansion of classical monocytes (CD14+/CD16-) (Selimoglu-Buet et al, Blood 20151). Further, measuring the relative fraction of classical monocytes, by itself, was capable of distinguishing CMML from reactive conditions and a mixed cohort of hematologic neoplasms. In this study, we aimed to validate these findings in a clinical and genetically annotated cohort of CMML and other hematologic malignancies with a focus on MDS, and normal age-matched controls. Methods: We profiled monocyte subsets in patients with a suspected diagnosis of CMML or MDS as previously described1 after obtaining institutional review board approval. Clinical demographics and genotyping of patient samples (52 gene TruSight panel, Illumina) were collected via retrospective chart review. Descriptive statistics were used to summarize clinical demographics, genotyping, and their association to classical monocytosis (CM). Receiver Operator Curves (ROC) were generated to test the sensitivity and specificity of the monocyte analysis and all calculated p-values were two-sided. Results: From October 2015 to May 2016 monocyte subsets were profiled in 159 genetically defined cases. The diagnosis of patients in our cohort included CMML (n=29), MDS (n=86), other myeloid malignancies (n=26), and reactive conditions (n=18). Within CMML cases the median age at diagnosis was 70 years, median hemoglobin, platelets, and monocyte counts were 10.9 g/dL, 102x109cells/L, and 2.05x109cells/L, respectively. As previously reported, CM was evident in all CMML cases and was capable of distinguishing CMML from normal age-matched controls. ROC analysis confirmed that the assay was capable of differentiating between these groups (AUC of 0.9592, p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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