Clinical, hematological and cytogenetic analysis of Chronic Myelomonocytic Leukemia in Pakistan: A single-center cross-sectional study.

Objective: The study was done to outline clinical, hematological, and cytogenetic profile of chronic myelomonocytic Leukemia (CMML) in Pakistani population. Study Design: Cross Sectional study. Setting: National Institute of Blood Diseases and Bone Marrow Transplantation (NIBD), Karachi, Pakistan. Period: January 2022- December 2023. Methods: All baseline investigations and clinical parameters of CMML patients were recorded. Bone marrow biopsy samples were taken and cytogenetic analysis was performed. Descriptive statistics were reported by using SPSS version 25.0. Association between two categorical variables was evaluated using Chi-square test and Fisher exact test. Results: A total of 29 patients were included in the study having median age 62 (5-85) years with male predominance (62.1%). The most common presenting complaint was lethargy in 29 (100%) patients, followed by weight loss in 22 (75.9%) and fever in 21 (72.4%). The median hemoglobin levels were 9.3 (ranging 5.4-14.2) g/dL, total leucocytes count (TLC) 39.4(ranging 3.4-145.8x10⁹/L and absolute monocyte count (AMC) of 5.5 (ranging1.14-61.54) x10⁹/L. Twenty-two (75.9%) patients had normal karyotype and 04(13.8%) had an abnormal karyotype. There was no statistical difference in patient outcomes in decitabine users and non-users. Conclusion: This was one of the first studies conducted on CMML Pakistani patients. The clinical and hematological demographics were similar to those reported by international studies. Further clinical follow up and treatment analysis would be important addition to the existing data done prospectively. Future longitudinal studies with inferential statistics are needed in this context at national level.