Subacute Monocytic Leukemia
Disease Details
Family Health Simplified
- Description
- Subacute monocytic leukemia, also known as chronic myelomonocytic leukemia (CMML), is a type of cancer that begins in blood-forming cells of the bone marrow and invades the blood, characterized by an increased number of monocytes.
- Type
- Subacute monocytic leukemia, also known as chronic myelomonocytic leukemia (CMML), is a type of leukemia. It is not typically associated with any specific type of genetic transmission as most cases are not inherited but rather occur due to acquired genetic mutations over a person's lifetime.
- Signs And Symptoms
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Signs and symptoms of subacute monocytic leukemia (a subtype of acute myeloid leukemia) may include:
1. Fatigue
2. Fever
3. Shortness of breath
4. Unusual bleeding or bruising
5. Frequent infections
6. Weight loss
7. Night sweats
8. Swollen lymph nodes
9. Pain or a feeling of fullness below the ribs due to an enlarged spleen or liver
10. Joint or bone pain - Prognosis
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Subacute monocytic leukemia, also referred to as chronic myelomonocytic leukemia (CMML), is a type of cancer that affects the blood and bone marrow. The prognosis for CMML can vary significantly based on several factors including the patient's age, overall health, genetic mutations present in the leukemia cells, and the specific subtype of CMML.
- **Prognosis**: Generally, CMML has a more variable prognosis compared to other forms of leukemia. The median survival time for patients with CMML is about 20-30 months, but this can vary widely. Some patients may live much longer with appropriate treatment and management, whereas others may have a more aggressive disease course. Prognostic scoring systems, such as the CMML-specific prognostic scoring system (CPSS), can help predict outcomes by considering factors such as blood cell counts, percentage of blasts in the bone marrow, and cytogenetic abnormalities. - Onset
- Subacute monocytic leukemia, also known as acute monocytic leukemia (AML-M5), typically has a rapid onset. Patients often experience symptoms such as fatigue, fever, bleeding, and infections that develop over weeks to a few months.
- Prevalence
- Subacute monocytic leukemia, a form of acute myeloid leukemia (AML), lacks specific prevalence data due to its rarity and the broader classification often used in leukemia statistics. If you need detailed population-based statistics, consulting leukemia-specific databases or recent epidemiological studies is recommended.
- Epidemiology
- Subacute monocytic leukemia, also known as chronic myelomonocytic leukemia (CMML), is a type of leukemia that involves the overproduction of monocytes. It primarily affects older adults, typically those over 60 years of age. The incidence rate is approximately 1-3 cases per 100,000 individuals annually. CMML is more common in males than females, with a male-to-female ratio of about 1.5 to 3:1. It is considered a part of the myelodysplastic/myeloproliferative diseases group. Environmental factors, such as exposure to radiation or certain chemicals, and genetic predispositions may contribute to the risk of developing CMML.
- Intractability
- Subacute monocytic leukemia, also known as chronic myelomonocytic leukemia (CMML), is a type of cancer that affects the blood cells. While it can be challenging to treat and manage, it is not necessarily intractable. Treatment options such as chemotherapy, targeted therapy, and stem cell transplants can be utilized, with varying degrees of success depending on the individual patient's condition and response to treatment. However, the disease can be aggressive in some cases, making management complex.
- Disease Severity
- Subacute monocytic leukemia, also referred to as chronic myelomonocytic leukemia (CMML), typically presents a severity that varies depending on the progression and response to treatment. It often progresses slowly but can be serious as it may evolve into acute myeloid leukemia (AML). Due to its variable nature, disease severity is generally assessed on a case-by-case basis by healthcare professionals.
- Healthcare Professionals
- Disease Ontology ID - DOID:8696
- Pathophysiology
- Subacute monocytic leukemia, also known as chronic myelomonocytic leukemia (CMML), involves the proliferation of monocytes and their precursors in the bone marrow, peripheral blood, and other tissues. The disease results from genetic mutations in hematopoietic stem cells leading to disrupted regulation and differentiation. These abnormalities cause an increased number of monocytes and myeloid cells, contributing to a wider range of symptoms and complications, including anemia, infections, and organ infiltration.
- Carrier Status
- Subacute monocytic leukemia, also known as acute monoblastic/monocytic leukemia (AMML, M5), is a subtype of acute myeloid leukemia (AML). There is no "carrier status" for this disease because it is not an inherited condition but rather a type of cancer that occurs due to acquired genetic mutations in the myeloid cells.
- Mechanism
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Subacute monocytic leukemia, also referred to as Chronic Myelomonocytic Leukemia (CMML), is a type of leukemia characterized by an increase in monocytes and immature monocytes in the bone marrow and peripheral blood.
### Mechanism:
CMML represents a clonal disorder of hematopoietic stem cells. The disease mechanism involves the unchecked proliferation of monocytic and granulocytic precursors due to mutations in these stem cells. This results in an accumulation of these cells in the bone marrow, peripheral blood, and often the spleen, leading to symptoms like anemia, increased infection risk, and splenomegaly.
### Molecular Mechanisms:
1. **Genetic Mutations**:
- **TET2**: Mutations in TET2 are prevalent in CMML and lead to abnormal hydroxymethylation and subsequent DNA methylation patterns.
- **SRSF2**: Mutations in the splicing factor SRSF2 are also common and result in aberrant mRNA splicing.
- **ASXL1**: These mutations can impact chromatin modification and gene expression.
- Other mutations: These include mutations in RUNX1, RAS pathway genes (e.g., NRAS, KRAS), and JAK2.
2. **Epigenetic Changes**:
- Epigenetic alterations, such as DNA methylation changes, histone modifications, and non-coding RNA deregulation, play significant roles in CMML pathogenesis.
3. **Dysregulated Signaling Pathways**:
- Signaling pathways such as the RAS-MAPK pathway and JAK-STAT pathway are often activated abnormally due to genetic mutations, leading to increased cell proliferation and survival.
4. **Bone Marrow Microenvironment**:
- The interaction between CMML cells and the bone marrow microenvironment, including cytokines and growth factors like GM-CSF, also contributes to disease progression.
Understanding these molecular mechanisms is critical for developing targeted therapies for CMML. - Treatment
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Subacute monocytic leukemia, also known as acute monocytic leukemia (AML M5), is a subtype of acute myeloid leukemia. Treatment typically involves the following:
1. **Chemotherapy**: Standard treatment often begins with intensive induction chemotherapy using cytarabine and an anthracycline (e.g., daunorubicin or idarubicin). This aims to induce remission by killing leukemic cells.
2. **Consolidation Therapy**: Once in remission, additional chemotherapy courses are administered to eradicate any remaining leukemia cells. High-dose cytarabine is commonly used in the consolidation phase.
3. **Stem Cell Transplant**: For patients who are considered high-risk or have relapsed, an allogeneic stem cell transplant may be recommended. This involves replacing the patient's bone marrow with healthy stem cells from a compatible donor.
4. **Targeted Therapy**: In some cases, targeted medications, such as FLT3 inhibitors (if there is a FLT3 mutation), may be used in combination with traditional chemotherapy.
5. **Supportive Care**: Supportive treatments are necessary to manage symptoms and side effects, including transfusions, antibiotics, antifungals, and medications to boost white blood cell counts.
Treatment plans are tailored to the individual patient, considering factors such as age, overall health, and genetic characteristics of the leukemia. Regular follow-up is essential to monitor for remission, relapse, and any long-term side effects of treatment. - Compassionate Use Treatment
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Subacute monocytic leukemia, also referred to as acute monoblastic/monocytic leukemia (AML M5), is a subtype of acute myeloid leukemia. Here are some compassionate use, off-label, or experimental treatments that have been explored:
1. **Venetoclax (Venclexta)**: Initially approved for chronic lymphocytic leukemia (CLL), Venetoclax is being studied for its effectiveness in treating AML, including monocytic subtypes.
2. **Glasdegib (Daurismo)**: Approved for newly diagnosed AML patients who are 75 years or older or who have comorbidities, Glasdegib is being investigated in other AML populations.
3. **FLT3 Inhibitors (e.g., Midostaurin)**: These are typically used in FLT3-mutated AML but are being explored for broader applications in various AML subtypes.
4. **CPX-351 (Vyxeos)**: A combination of daunorubicin and cytarabine, CPX-351 is approved for secondary AML but is under investigation for a wider range of AML presentations.
5. **Hypomethylating Agents (e.g., Azacitidine, Decitabine)**: Approved for myelodysplastic syndromes and older AML patients, these agents are being explored in younger and fitter patients as well.
6. **Immunotherapy Approaches**: Experimental treatments like NK cell therapy, CAR-T cell therapy, and various checkpoint inhibitors are in early stages of research for AML, including monocytic subtypes.
7. **Targeted Therapies for Specific Mutations**: Investigations are ongoing into therapies targeting specific genetic mutations found in AML (e.g., IDH1/2 inhibitors).
Compassionate use programs make these and other experimental treatments available to patients with no other treatment options. Always consult with a healthcare provider for the most current and personalized medical advice. - Lifestyle Recommendations
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Subacute monocytic leukemia (also called chronic myelomonocytic leukemia or CMML) is a type of leukemia characterized by the overproduction of monocytes (a type of white blood cell). Lifestyle recommendations for individuals diagnosed with CMML include:
1. **Healthy Diet**: Emphasize a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats to support overall health and immune function.
2. **Regular Exercise**: Engage in regular physical activity as tolerated. This can help maintain strength and reduce fatigue, but it should be tailored to individual energy levels and physical capabilities.
3. **Avoiding Infections**: Practice good hand hygiene, avoid large crowds or sick individuals, and stay up to date with vaccinations, as recommended by your healthcare provider, to reduce the risk of infections.
4. **Stress Management**: Use techniques such as mindfulness, meditation, or counseling to manage stress, which can improve overall well-being and potentially modulate immune function.
5. **Adequate Rest**: Ensure sufficient sleep and rest to help the body recover and maintain energy levels.
6. **Medication Adherence**: Take prescribed medications as directed, and attend all follow-up appointments to monitor disease progression and treatment efficacy.
7. **Avoid Smoking and Limit Alcohol**: Smoking can impair immune function and overall health, while excessive alcohol can interfere with liver function and other aspects of health.
8. **Support System**: Engage with support groups or counseling services to cope with the emotional and psychological aspects of living with CMML.
It's essential to work closely with your healthcare team to develop an individualized plan that considers your specific situation and medical condition. - Medication
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For subacute monocytic leukemia, which is more commonly referred to as chronic myelomonocytic leukemia (CMML), treatment typically involves:
**Medications:**
1. **Hypomethylating Agents:**
- Azacitidine
- Decitabine
2. **Chemotherapy:**
- Cytarabine (often used in combination with other drugs)
3. **Targeted Therapy:**
- Ruxolitinib (for cases with certain genetic mutations)
4. **Supportive Care:**
- Transfusion of blood products
- Antibiotics for infection management
Treatment strategies may vary based on the patient's specific condition, including genetic mutations and overall health. - Repurposable Drugs
- Currently, there is no specific information available on repurposable drugs for subacute monocytic leukemia (a subtype of acute myeloid leukemia, AML). Drug repurposing is an ongoing area of research, and new findings could emerge in the future. Standard treatment typically includes chemotherapy and may involve drugs such as cytarabine and anthracyclines. Participation in clinical trials or consulting with a healthcare provider for the latest treatment options is advisable.
- Metabolites
- Subacute monocytic leukemia, also known as chronic myelomonocytic leukemia (CMML), involves several altered metabolites. Key metabolites include elevated levels of lactic acid, uric acid, and various cytokines such as interleukins. Additionally, there may be abnormalities in purine metabolism and disruptions in amino acid levels. Accurate diagnosis and monitoring often require detailed metabolic profiling.
- Nutraceuticals
- There are no established nutraceuticals specifically proven to treat subacute monocytic leukemia (a subtype of acute myeloid leukemia). Treatment typically involves chemotherapy and other medical interventions. Always consult a healthcare professional before considering any supplements or alternative treatments as part of a cancer care plan.
- Peptides
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Subacute monocytic leukemia (M4) is a subtype of acute myeloid leukemia characterized by an increase in monocytic cells in the blood and bone marrow. Information specific to peptides in relation to this disease is limited. Peptides associated with leukemia generally would involve signaling pathways or therapeutic targets but are not specific to subacute monocytic leukemia.
There's no established use of peptides or specific details that are commonly referenced directly for subacute monocytic leukemia in the current literature. Research might be ongoing in targeted therapies, including peptides, but clear data may not be available now.