Recent insights in the pathophysiology of chronic myelomonocytic leukemia

                                                                                                                                                    Aïsha Mientjes



Speaker: Eric Solary       

Department: Hematology

Subject: Recent insights in the pathophysiology of chronic myelomonocytic leukemia. 

Location: Erasmus MC  

Date: 19-12-2016           

The presentation was about CMML (chronic myelomonocytic leukemia), the genetic background of this disease and the treatments. The speaker begun by explaining a little bit about different monocytes and how CMML is defined. You need a certain level of white blood cells and monocytosis for a period of three months. In patients who suffer from this disease, monocyte levels are irregular. There is an increased fraction of classical monocytes. This means that monocyte phenotype can be used to detect the disease or an early ‘form’, called MDS. The speaker then went on to describe the genetic background of the disease. Several mutations occur in patients, 40 recurrently mutated genes were found in 49 patients. In CMML patients, the majority of the hematopoietic genes are mutated, there is a linear accumulation of mutations. The most mutated cells have a growth advantage and branching events can occur. CMML is a very severe disease and the main method of treatment is currently the use of hypomethylating agents. Baseline DNA methylation distinguishes responders and non-responders. Using this, you can predict CMML resistance to hypomethylating agents. After a conclusion, the presentation came to an end.

Actually, the majority of the presentation was new for me. I knew nothing about CMML before coming to this presentation. Moreover, this was my first HP Seminar, so I was excited to find out how these would take place. I learned a lot about the disease (how it is diagnosed, what is happening inside the body), but I also learned a lot about genetics and how several mutations can lead to a disease like this. Additionally, I found out a lot about different types of treatment and how the correct treatment for a patient is determined. The speaker had a very interesting flowchart describing how they determine what treatment is best suited. I really enjoyed the topic of the lecture, however it was often hard to follow. As someone with practically no background in the field, a lot of terms were knew to me and remained vague throughout the entirety of the seminar. The seminar was also given at quite a high speed. Despite this, I learned a lot. I really enjoyed finding out how different types of treatment are tested and implemented, given that I had very little knowledge about this.


This picture shows the survival rate of CMML patients, showing that CMML is truly a very severe disease.

In conclusion, this was a difficult seminar to follow but the topic was very interesting and educational. Even though medicine is maybe not the field I would really like to pursue, I would like to get to know more about this topic.



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