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The hypomethylating agents (HMA) azacitidine (AZA) 1 , 2 and decitabine (DAC) 3 , 4 are active in Chronic Myelomonocytic Leukemia (CMML) with overall response rates (ORR) of 40–70%, translating into median overall survivals (OS) of 12–22 months. Response to HMA in these CMML cohorts was mostly evaluated according to IWG-2006 criteria, 5 which do not assess improvement of myeloproliferative features nor quality of life. In myelodysplastic syndroms (MDS) patients treated with HMA, these criteria have limited impact in predicting OS. 6 , 7 Normalization of WBC and monocyte counts, regression of splenomegaly or other extra-medullary disease, and improvement of quality of life have been reported in CMML patients treated with HMA 1 , 8 and studies in MDS and primary myelofibrosis have shown that symptom improvement could be correlated to a prolonged OS. 9 , 10
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Duchmann et al. (2017) studied this question.
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