慢性粒单核细胞白血病（CMML）是一种罕见且可能未被充分诊断的血液恶性肿瘤。由于其罕见性和诊断上的细微差别，许多患者被转诊至三级转诊中心，尽管许多患者继续在社区环境中接受护理。鉴于相关骨髓恶性肿瘤的设施类型不同，结果存在差异，我们假设，与在非学术中心 (NAC) 治疗的患者相比，在学术中心治疗的 CMML 患者的生存率可能有所改善。使用国家癌症数据库 (NCDB)，我们确定了 6290 CMML 患者并收集有关人口统计、合并症、治疗和生存的数据。我们还进行了倾向匹配分析来控制基线差异。我们发现学术中心的患者比在学术中心的患者具有更高的中位总生存期 (OS)（17.7 个月 vs 14.7 个月）和 5 年 OS（19.1% vs 15.3%）。 NAC。此外，与在 NAC 治疗的患者相比，在学术中心治疗的患者也更有可能接受造血干细胞移植。学术机构和 NAC 之间的治疗开始时间总体相似。我们对最大的 CMML 患者可用数据集之一的研究支持了在诊断后将 CMML 患者转诊至学术中心以优化这种罕见血液恶性肿瘤的治疗结果的重要性。版权所有 © 2024 Elsevier Inc 。 版权所有。

Chronic myelomonocytic leukemia (CMML) is a rare and likely underdiagnosed hematologic malignancy. Due to its rarity and nuances in diagnosis, many patients are referred to tertiary referral centers, although many continue to be cared for in the community setting. Given discrepancies in outcomes based on facility type in related myeloid malignancies, we hypothesized that CMML patients treated at academic centers may have improved survival as compared to patients treated at nonacademic centers (NACs).Using the National Cancer Database (NCDB), we identified 6290 patients with CMML and collected data on demographics, comorbidities, treatment, and survival. We also performed a propensity matched analysis to control for baseline differences.We found that patients at academic centers had higher median overall survival (OS) (17.7 months vs 14.7 months) and 5-year OS (19.1% vs 15.3%) than patients at NACs. In addition, patients treated at an academic center were also more likely to receive hematopoietic stem cell transplant as compared to those treated at NACs. Time to treatment initiation was overall similar between academic and NACs.Our study of one of the largest available datasets of CMML patients supports the importance of referring CMML patients to academic centers upon diagnosis to optimize outcomes in this rare hematologic malignancy.Copyright © 2024 Elsevier Inc. All rights reserved.