Myeloid neoplasms with oligomonocytosis exhibit heterogenous pathologic and genetic features

Vandana Baloda; Raniah Al Amri; Pranav P Patwardhan; Sara A Monaghan; Erika M Moore; Bryan Rea; Miroslav Djokic; Nidhi Aggarwal; Grant C Bullock; Yen-Chun Liu; Svetlana Yatsenko; Nathanael G Bailey

doi:10.1016/j.modpat.2025.100823

Back

Myeloid neoplasms with oligomonocytosis exhibit heterogenous pathologic and genetic features

Journal article

Open access

Peer reviewed

Myeloid neoplasms with oligomonocytosis exhibit heterogenous pathologic and genetic features

Vandana Baloda, Raniah Al Amri, Pranav P Patwardhan, Sara A Monaghan, Erika M Moore, Bryan Rea, Miroslav Djokic, Nidhi Aggarwal, Grant C Bullock, Yen-Chun Liu, …

Modern pathology, Vol.38(10), 100823

10/2025

DOI: 10.1016/j.modpat.2025.100823

PMID: 40541867

Files and links (1)

url

https://doi.org/10.1016/j.modpat.2025.100823View

Published (Version of record) Open Access

Abstract

The criteria used to classify patients with myeloid neoplasms and monocytosis have changed in the 5th edition of the World Health Organization Classification (WHO5) and the International Consensus Classification (ICC). While both classifications have reduced the absolute monocyte count threshold for chronic myelomonocytic leukemia (CMML) to 0.5×10 /L, the ICC has also introduced new morphologic criteria for CMML. We studied the effect of these changes on a large cohort of myeloid neoplasms with white blood cell count <13x10 /L and blasts <20% that were previously classified using the 4th revised edition of the WHO (WHO4r). The lower monocyte threshold might reclassify ∼20% of WHO4r-defined MDS as myelodysplastic-type CMML (MD-CMML) in the new classifications. This change led to an 84% increase in MD-CMML by WHO5 criteria. The number of MD-CMML cases in the cohort decrease from 107 by WHO5 to 40 by ICC criteria due to the morphologic criteria. New ICC criteria remove 55% of WHO4r-defined MD-CMML patients from the category, and these and other patients (13% of our cohort) are not classifiable by ICC criteria. ICC-defined CMML enriches for CMML-like genetic signatures, but we find that genetic classification and genetically informed risk models predict outcome better than monocyte counts or morphologic features.

chronic myelomonocytic leukemia

myelodysplastic/myeloproliferative neoplasms

myelodysplastic syndromes

Details

Title: Subtitle: Myeloid neoplasms with oligomonocytosis exhibit heterogenous pathologic and genetic features
Creators: Vandana Baloda - UPMC Health System
Raniah Al Amri - University of Pittsburgh Medical Center
Pranav P Patwardhan - UPMC Health System
Sara A Monaghan - University of Pittsburgh Medical Center
Erika M Moore - University of Pittsburgh Medical Center
Bryan Rea - University of Pittsburgh Medical Center
Miroslav Djokic - NeoGenomics (United States)
Nidhi Aggarwal - University of Pittsburgh Medical Center
Grant C Bullock - University of Iowa
Yen-Chun Liu - St. Jude Children's Research Hospital
Svetlana Yatsenko - Stanford Medicine
Nathanael G Bailey - University of Pittsburgh
Resource Type: Journal article
Publication Details: Modern pathology, Vol.38(10), 100823
DOI: 10.1016/j.modpat.2025.100823
PMID: 40541867
NLM abbreviation: Mod Pathol
ISSN: 1530-0285
eISSN: 1530-0285
Publisher: ELSEVIER SCIENCE INC
Grant note: University of Pittsburgh, Department of PathologyNational Institutes of Health: UL1TR001857
The project was supported by funding provided by the University of Pittsburgh, Department of Pathology and was supported by the National Institutes of Health through grant number UL1TR001857.
Language: English
Electronic publication date: 06/18/2025
Date published: 10/2025
Academic Unit: Pathology
Record Identifier: 9984832184002771

Metrics

9 Record Views