# How I diagnose and treat chronic myelomonocytic leukemia

## TL;DR

This paper discusses the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) based on updated WHO and ICC standards and new prognostic systems.

## Contribution

The paper provides a systematic overview of current diagnostic and therapeutic approaches to CMML informed by recent classification and prognostic advancements.

## Key findings

- The 2022 WHO and ICC standards have significantly revised CMML diagnostic and classification criteria.
- New prognostic scoring systems like CPSS-Mol and BLAST-Mol integrate cytogenetic and molecular data.
- Treatment decisions should consider prognosis, symptoms, disease progression, and patient preferences.

## Abstract

慢性粒-单核细胞白血病（CMML）是一种同时具有骨髓增生异常和骨髓增殖特征的起源于造血干/祖细胞的髓系肿瘤。2022年第五版WHO诊断标准（WHO 2022）分类标准和国际共识标准（ICC）中对CMML的诊断、分型标准做了较大的修改。此外，在既往提出的CMML特异性预后积分系统（CPSS）基础上结合细胞遗传学和分子学新近又相继提出了CPSS-Mol、BLAST和BLAST-Mol等新的预后积分系统，CMML患者的治疗方案应在预后分组的基础上结合患者的症状、疾病负荷（血细胞减少或增殖表现）、疾病进展证据以及患者的个体状况和意愿综合考虑后做出。本文结合笔者诊治的病例对CMML的诊断和治疗要点与认识现况做了系统阐述。