Primate Monocytes - CD14, CD16 - Ziegler-Heitbrock

Accumulation of classical monocytes defines a subgroup of MDS that frequently evolves into CMML.

Abstract

Even though the diagnosis criteria of chronic myelomonocytic leukemia (CMML) have been recently revised by the WHO,1 recognition of this disease can be challenging. We demonstrated recently that a percentage of classical monocytes CD14++CD16- (MO1) ≥94% of total monocytes, as measured by flow cytometry, could rapidly and efficiently distinguish a CMML from a reactive monocytosis with a specificity of 95.1% and a sensitivity of 91.9%.2 The association between MO1 accumulation and CMML was subsequently validated3 and proposed as an additional diagnostic modality in CMML.4,5 A relative monocytosis, defined as a percentage of peripheral blood monocytosis ≥ 10%, has been described in a subgroup of MDS likely to evolve into genuine CMML.6–9 Here, we compare the monocyte subset repartition in CMML and in MDS. Between January 2015 and March 2017, we analyzed 158 CMML patients and 84 MDS patients for whom the diagnosis was made according to the 2008 WHO classification10, following local ethical committee’s rules. Of the 158 patients with CMML, 152 (96%) fulfilled the latest 2016 WHO criteria that include both a persistent peripheral blood monocytosis ≥ 1 x 109/L and monocytes accounting for ≥10% of the white blood cell differential count.