A multivariate analysis of prognostic factors in chronic myelomonocytic leukaemia according to the FAB criteria

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Abstract
In an attempt to characterize the prognostic significance of the main initial clinical, hematological and biochemical features of chronic myelomonocytic leukemia according to the FAB criteria, 29 such patients were analyzed by means of univariate and multivariate statistical methods. At the time of the analysis 21 patients had died, with a median survival for the overall series of 8.2 months. The univariate analysis identified three parameters associated with poor prognosis: high monocyte counts, low platelet counts and splenomegaly. When all the initial features were included in a multiple regression model, only high monocyte counts and spleen enlargement retained their unfavorable prognostic influence (P = 0.002 and P = 0.02, respectively). Based on the presence or not of these prognostic factors, two populations of patients with different survival (median survival 5.6 and 16.5 months, respectively, P < 0.005) could be identified. It seems therefore that monocytic proliferation serves not only as the diagnostic marker for chronic myelomonocytic leukemia but also as the most important feature in the assessment of the patient''s prognosis.