Chronic myelomonocytic leukemia.

Chronic myelomonocytic leukemia (CMML) has dysplastic and proliferative features. The median age of patients with CMML is 70 years; the median survival is approximately 2 years. Various chemotherapy regimens have been used with only modest success. When the proliferative phase prevails, hydroxyurea is the treatment of choice. For younger patients with high-risk CMML, an allogeneic bone marrow transplantation should be considered. If a donor cannot be identified, then combination acute myeloid leukemia-type therapy followed by an autologous stem cell or marrow transplant should be offered. Clinical trials should be considered if available because the overall results of therapeutic interventions are far from optimal.