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‹ Tue · 28 Apr 2026
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Chronic myelomonocytic leukemia beyond the marrow: biology, patterns, and management of extramedullary disease

Recognizing when chronic myelomonocytic leukemia spreads beyond bone marrow matters, since it signals worse outcomes and may guide earlier transplant decisions.

This comprehensive review in Leukemia synthesizes the current understanding of extramedullary disease (EMD) in CMML, demonstrating its underrecognized occurrence (~10-15% of patients), association with adverse RAS-MAPK mutations and ASXL1 lesions, and worse outcomes including higher AML transformation rates. The review provides a practical integrated diagnostic strategy (PET-CT + biopsy + clonality testing) and supports early transplant consideration in EMD-positive CMML.

What the study was

Study design
Narrative/systematic review
Population
CMML patients with extramedullary disease
Category
Treatment Innovation
Maturity
Validated
Journal
Leukemia

Why it surfaced

High-quality Leukemia review on clinically underrecognized CMML manifestation with practical diagnostic and management guidance. CMML EMD is an adverse prognostic feature relevant to MPN/MDS watchlist.

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