慢性粒单核细胞白血病合并淋巴/浆细胞肿瘤9例临床分析OA

Objective:To describe the clinical characteristics and prognosis of chronic myelomonocytic leukemia(CMML)patients co-occurrent with lymphoid/plasma cell neoplasms(LP-CMML).Methods:We retrospectively identified nine LP-CMML cases who visited the First Affiliated Hospital of Nanjing Medical University between January 2016 and August 2025,and compared their features with de novo CMML(DN-CMML).Results:The median age of LP-CMML patients was 66(58,76)years,with 8(88.9％)being male.All patients were classified as CMML-1.The most common co-existing lymphoid/plasma cell neoplasm was diffuse large B-cell lymphoma(3 cases).No differences were found between LP-CMML and DN-CMML in basic clinical characteristics,cytogenetic risk stratification and disease risk stratification.Based on the sequence of occurrence,4 patients were classified as therapy-related CMML(tCMML)and 5 as non-tCMML.Compared with the non-tCMML patients,tCMML patients were younger(P=0.016)and the dysplastic phenotype predominance(P=0.048).Dynamic monitoring of one tCMML patient revealed a pre-existing CMML precursor state at the time of lymphoid neoplasm diagnosis,with clonal evolution during the disease course.Survival analysis showed shorter median overall survivals(6 months vs.40 months,P＜0.001)and median progression free survivals(5 months vs.29 months,P＜0.001)for LP-CMML than those of DN-CMML.No difference was found in survivals between tCMML and non-tCMML subgroups.Conclusion:LP-CMML indicates clinical heterogeneity and poor survival.