From the Guidelines
Treatment for conditions associated with abnormal monocyte levels should be guided by the underlying cause and disease phenotype, with a focus on supportive therapy, cytoreductive therapy, or hypomethylating agents, depending on the specific condition and blast count. For patients with myelodysplastic (MD) or myeloproliferative (MP) chronic myelomonocytic leukemia (CMML), the treatment strategy should be decided based on the disease hematologic phenotype and the number of blasts in the bone marrow (BM) 1.
- Patients with MD-CMML and less than 10% blasts in BM should be managed with supportive therapy aimed at correcting cytopenias, including the use of erythropoietic stimulating agents for severe anemia (Hb ≤ 10g/dL and with serum erythropoietin ≤ 500 mU/dL) 1.
- In patients with MD-CMML with a high number of blasts (≥10% in BM, ≥5% in the blood), supportive therapy should be integrated with the use of hypomethylating agents (5-azacytidine or decitabine), and allo-SCT may be offered within clinical trials 1.
- Patients with MP-CMML with a low number of blasts should be treated with cytoreductive therapy, with hydroxyurea as the drug of choice to control proliferative myelomonocytic cells and reduce organomegaly 1.
- Patients with MP-CMML and a high number of blasts should receive blastolytic therapy with polychemotherapy followed, when possible, by allo-SCT, or chemotherapy to maintain Quality of Life if allo-SCT is not an option 1. Regular monitoring of blood counts and disease progression is essential to adjust treatment strategies and improve patient outcomes.
From the Research
Treatment Options for Conditions Associated with Abnormal Monocyte Levels
- Monocytes play a crucial role in the immune system, and their dysfunction can lead to various conditions, including autoimmune diseases and immunopathologies 2, 3.
- Treatment options for conditions associated with abnormal monocyte levels include:
- Immunomodulators, such as interferon beta and glatiramer acetate, which can help regulate the immune system and reduce inflammation 4, 5.
- Immunosuppressants, such as mitoxantrone and azathioprine, which can help reduce the immune system's abnormal activity 4, 5.
- Monoclonal antibodies, such as natalizumab, which can help target specific cells or proteins involved in the condition 4, 5.
- The choice of treatment depends on the specific condition, its severity, and the individual's overall health 5.
- In some cases, epigenetic alterations may be associated with monocyte immune dysfunctions, and targeting these alterations may be a potential therapeutic strategy 6.
Specific Conditions and Treatment Options
- Multiple sclerosis (MS): treatment options include interferon beta, glatiramer acetate, natalizumab, and mitoxantrone 4, 5.
- HIV-1 infection: treatment options may involve targeting epigenetic alterations associated with monocyte immune dysfunctions 6.
- End-stage renal disease (ESRD): treatment options may involve regulating the immune system and reducing inflammation, as monocytes play a key role in immune dysfunctions in ESRD 3.