Chronic Myelomonocytic Leukemia (CMML)
Supplemental Studies
- Immunologic stains (flow and sections)
- Leukemic cells
- Positive: CD33, CD13, CD163
- Variable: CD14, CD68, CD64
- Occasional aberrant expression:
- Decreased CD13, CD14, CD15, CD64, CD36, HLA-DR
- Overexpression of CD2, CD56
- Increased CD34 may indicate transformation to AML
- CAUTION - monoblasts and promonocytes are often CD34 negative
- Morphologic assessment is more important than simple CD34 count
- Plasmacytoid dendritic cells
- Positive: CD123, CD14, CD43, CD68, CD68R, CD45A, CD4, Granzyme B
- Weak: CD33
- Variable: CD56, CD2, CD5
- Negative: TIA1, perforin
- Nonspecific clonal cytogenetic abnormalities present in 20-40%
- Following are not present, by definition
- BCR-ABL1 (including p190 isoform), PDFGRA, PDFGRB
- Nonspecific molecular abnormalities present in up to 70%, including
- RAS (40%), TET2, CBL, JAK2, RUNX1
