Although chronic myelomonocytic leukemia (CMML) responds to hypomethylating agents (HMAs), new monotherapies and combinations are needed, according to a study involving 151 individuals.

The largest retrospective analysis done to date comprised patients at low, intermediate-1, intermediate-2, and high-risk who received either azacitidine, decitabine, or combinations. Among the results:

• At a median of 17 months follow-up, overall response rate was 75%.
• Overall complete response rate was 41%.
• Patients <70 years of age tended to experience better overall survival.
• Higher hemoglobin levels, absence of blast in peripheral blood, and lower risk score also predicted better overall survival.
• Complete response in patients receiving decitabine was 58%, vs 21% for azacytidine.
• 9% received allo-SCT after a median of 4 cycles of HMAs.
• Half had HMA failure; overall survival in these patients was only 7 months.