CMML

[choijk]

I am so sorry to be bombarding everyone with my posts. The more I research, the more questions I have and I don’t know who to turn to except here.

Yesterday I learned that CMML is a subset of MDS/MPD but couldn’t really find any information that was broken down by a layman’s terms. If anyone can explain it or share their thoughts and experiences with me, I would greatly appreciate it.

The reason I would like to know more information on CMML is because based on the BMB, my dad was diagnosed with MDS/MPD. Our doctor indicated that he felt hesitant with the diagnosis because my dad didn’t really fit in either category. However, a hematologist from UCLA (our third opinion) indicated that he did not agree with the MDS/MPD diagnosis and thought that my dad is RCMD. THe reason for his finding was because he said that it was the bone marrow itself that was not producing effective red blood cells and that the findings from the BMB was consistent with the dx of MDS. Thus, this is where the dx of RCMD comes in because although my dad’s rbc are the only ones that are currently affected as he is receiving supportive care (transfusions + weekly Procrit shots), his wbc remains within the normal limits except that his monocytes tend to be slightly higher from 13-18%.

I found that the patients dx with CMML also tend to have higher monocytes in their white blood cell counts.

I plan to bring this up to my doctor in our next visit, which is scheduled for next week. Although my parents and I love my doctor, we just don’t know who to believe. Does my dad have MDS/MPD or is he RCMD. Or is it possible to have MDS/MPD and also be RCMD? I have no idea.

If anyone can provide any information or shed any light please……

[Neil]

Hi June,
RCMD is a classification of MDS. It was one created by the World Health Organization. Prior to the WHO system of classification we had the FAB system (french, American, British). Under this system many of us were unclassified since we did not fit the criteria used at that time.
There are some subtle differences in the 2 systems, but the use if the risk levels under the IPSS()International Prognostic Scoring System) makes the classifications somewhat more meaningful.
Under the WHO system CMML might be considered to be Leukemia, but not under the FAB system. The patient has the same characteristics regardless. Are treatments different? It seems to be a means of seperating patients into more precise classes that may at some future time have more meaning with respect to treatment options.
You might ask the doc why he is not classified as RA —Refractory Anemia.

[choijk]

Thanks again Neil for answering my questions. Our hematologist indicated that my dad would be considered RA if it was under the FAB system. However under the WHO system, he indicated that it is possible that he is RCMD because it seems like 2 of his lines are affected – rbc because of his low hgb and in regards to his wbc, I forget. I usually write down everything what the doctor indicates but this was in the beginning and I was so in shock that it was a lot of information to process. If anyone can give me any other insight to CMML, it would be great. Thank you again for everything!

[Jimbob]

June,
In addition to the response to your private message, google “chronic myelomonocytic leukemia” for more information on CMML but do not be distressed by any negative info or anything over 2 years old. Things have improved a lot recently.
Jim

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