Unveiling relative lymphopenia and elevated monocyte-to-lymphocyte count as novel independent adverse prognostic factors in chronic myelomonocytic leukemia (CMML)-Proposal of the objective prognostic index for CMML (OPIC).

ABSTRACT: Chronic myelomonocytic leukemia (CMML) shows marked prognostic heterogeneity. Although leukocytosis is a recognized adverse prognostic factor, the contribution of its individual components remains insufficiently defined. In a cohort of 240 patients classified according to International Consensus Classification (ICC) and World Health Organization (WHO) 2022 criteria-including 23% with oligomonocytic CMML-we evaluated the prognostic impact of neutrophil and monocyte percentage, along with surrogate markers of their relative increase, including relative lymphopenia (<20%) and elevated monocyte-to-lymphocyte ratio (MLR > 1). Both relative lymphopenia and MLR > 1 emerged as independent adverse prognostic factors, correlating with adverse mutations (TP53, RAS pathway) and high-risk clinic

SUBMITTER: Calvo X 

PROVIDER: S-EPMC12849217 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature