Chronic myelomonocytic leukaemia and MDS/MPN overlap neoplasms: lines of therapy
4 standard-of-care settings across 2 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| Fit | Higher-risk CMML, fit with a donor | Allogeneic haematopoietic stem cell transplant, often after hypomethylating-agent cytoreduction; the only curative option. | NCCN · Category 2A | 89 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Higher-risk or symptomatic CMML, not transplant candidate | Azacitidine or decitabine (or oral decitabine-cedazuridine) until progression; supportive care with transfusion and growth factors. | NCCN · Category 2A | 89 | |
| All comers | Proliferative CMML with symptomatic leucocytosis or splenomegaly | Hydroxyurea (superior to etoposide in the randomised GFM trial); ruxolitinib in trials for symptomatic proliferative disease. | Wattel et al., Blood 1996 (hydroxyurea vs etoposide) | 55 | |
| All comers | Juvenile myelomonocytic leukaemia | Allogeneic transplant; azacitidine as bridging therapy (EMA approval 2019 for JMML); watchful waiting for some CBL- or Noonan-associated cases that regress spontaneously. | EWOG-MDS / COG JMML recommendations | 89 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.