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In the World Health Organization (WHO) 2022 classification of chronic myelomonocytic leukemia (CMML), the cutoff for absolute monocyte values was lowered from 1.0 × G/L (2016) to 0.5 × G/L to incorporate cases formerly referred to as oligomonocytic CMML. The prevalence of this criterion in the general population and its potential association with demographic parameters and comorbidities is unclear. In order to answer these questions, we used the previously published LEAD (lung, heart, social, body) cohort (ClinicalTrials.gov; NCT01727518), which is a longitudinal, observational, population-based Austrian cohort aiming to investigate the impact of genetic, environmental, social, developmental, and ageing factors on respiratory health and associated comorbidities through life. The prevalence of the 2022 criterion was 11.976% in the general population, as compared to 0.747% of the 2016 criterion. In the descriptive analysis, individuals with the 2022 criterion as compared to those without this criterion were more often males, had a greater height and bodyweight, more frequently suffered from cardiovascular (CVD) and chronic obstructive pulmonary disease (COPD), and had higher C‑reactive protein (CRP) values. In the multivariable logistic regression, higher CRP, COPD, and CVD were significantly associated with the 2022 criterion. Our results show that in the general population, the 2022 CMML blood diagnostic criterion is 16 times more common than the 2016 criterion. The 2022 criterion is associated with CVD, COPD, and inflammation, which should be considered in the interpretation of this criterion in clinical practice.
Geißler et al. (Mon,) studied this question.