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

In an attempt to characterize the prognostic significance of the main initial clinical, haematological and biochemical features of chronic myelomonocytic leukaemia according to the FAB criteria, 29 such patients were analysed 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 unfavourable 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 less than 0.005) could be identified. It seems therefore that monocytic proliferation serves not only as the diagnostic marker for chronic myelomonocytic leukaemia but also as the most important feature in the assessment of the patient's prognosis.