Treatment Options

Traditionally, the management of CMML has focused on disease-associated clinical symptoms, symptoms associated with marrow failure (i.e., anemia and thrombocy-topenia), and symptoms of increased myeloproliferation (i.e., increased WBC count, organomegaly, and hyperme-tabolic state). For this purpose, an intuitive stratification into "dysplastic" CMML, resembling myelodysplastic syndrome (MDS), and "proliferative" CMML, resembling MPD, seems practical.2-4 MDS CMML is primarily managed with supportive care, and cytotoxic therapy is added when signs of proliferative disease, characterized by an increased WBC count and/or organ involvement or constitutional symptoms, appear. MPD CMML is managed with cytotoxic therapy plus supportive care.

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