Prognostic factors and scoring systems in chronic myelomonocytic leukemia: A retrospective analysis of 37 patients
Çalışmada kronik myelomonositik lösemili (KMML) olgularımızın farklı sınıflama ve prognostik skorlama sistemlerine göre hematolojik, klinik ve demografik özelliklerini değerlendirmeyi amaçladık. Şubat 1994 ile Aralık 2005 arası tanı almış 37 KMML hastası retrospektif olarak değerlendirildi. Erkek ka...
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| Veröffentlicht in: | Uluslararası hematologi-onkoloji dergisi 2008, Vol.18 (4), p.193-200 |
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| description | Çalışmada kronik myelomonositik lösemili (KMML) olgularımızın farklı sınıflama ve prognostik skorlama sistemlerine göre hematolojik, klinik ve demografik özelliklerini değerlendirmeyi amaçladık.
Şubat 1994 ile Aralık 2005 arası tanı almış 37 KMML hastası retrospektif olarak değerlendirildi. Erkek kadın oranı 29/8, tanı anındaki medyan yaş 72 idi. Hastaların medyan izlem süresi 12 aydı (1-119 ay). Olguların FAB'a göre %70.3'ü KMML-MP, diğerleri KMML-MD olarak sınıflandırıldı. WHO'ya göre, %86.5'i KMML-I, %13.5'i KMMLII olarak yeniden sınıflandırıldı. Karyotipik analiz 22 hastada yapılabildi.
Medyan laboratuar değerlerinden hemoglobin (Hb) 9 g/dL (6.1-14 g/dL), beyaz küre (WBC) 9.7 x 109/L (1.8-157 x 109 /L), periferal monosit sayısı 3.5 x 109/L (1.2-50 x 109/L), trombosit 85 x 109/L (6-992 x 109/L) idi. Splenomegali 11 hastada (%29.7) gözlendi. 14 olguda (%37.8) medyan 11 ay sonra (1-90 ay) AML gelişti ve transformasyon sonrası medyan 11 ay yaşadıkları (1-90 ay) izlendi. OS 12 aydı [MD (miyelodisplastik) tipinde 12 ay, MP (miyeloproliferatif) tipinde 25 ay, p=0.3]. Uluslar arası skorlama sisteminde (IPSS) 13 KMML-MD hastasına uygulanabildi (WBC < 12 x 109/L). Hastalar yayınlanmış skorlama sistemlerine göre yeniden değerlendirildi. Risk grupları arasında anlamlı OS farkı mevcuttu (Modifiye Bournemouth skorunda:p= 0.039, Duesseldorf skorunda:p= 0.01, IPSS: p=0.003). Multivaryant analizi yapıldığında Hb (< 10 g/dL) ve kemik iliği blast yüzdesinin (>=; %10) prognostik anlam taşıdığı görüldü (p= 0.03, p= 0.002). Güncel prognostik skorlama sistemlerinin KMML'de kullanımı cesaret verici olsa da klinikte karar vermede daha spesifik prognostik faktörlere ihtiyaç olduğu kanısındayız.
Main objective of this study was to evaluate hematological, clinical and demographic features of our chronic myelomonocytic leukemia (CMML) patients according to different classification systems and prognostic variables. Thirty-seven consecutive patients with CMML diagnosed between February 1994 and December 2005 were evaluated retrospectively. Male and female ratio was 29/8. The median age at diagnosis was 72. Median follow-up time for all patients was 12 months (1-119 months). 70.3% of patients were classified as CMML-MP, others were classified as CMML-MD type according to FAB. When they were reclassified according to WHO, 86.5% of them were CMML-I and 13.5% were CMML-II. Karyotyping analysis could be made in only 22 patients.
Median laboratory values were as follows: hemoglob |
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Şubat 1994 ile Aralık 2005 arası tanı almış 37 KMML hastası retrospektif olarak değerlendirildi. Erkek kadın oranı 29/8, tanı anındaki medyan yaş 72 idi. Hastaların medyan izlem süresi 12 aydı (1-119 ay). Olguların FAB'a göre %70.3'ü KMML-MP, diğerleri KMML-MD olarak sınıflandırıldı. WHO'ya göre, %86.5'i KMML-I, %13.5'i KMMLII olarak yeniden sınıflandırıldı. Karyotipik analiz 22 hastada yapılabildi.
Medyan laboratuar değerlerinden hemoglobin (Hb) 9 g/dL (6.1-14 g/dL), beyaz küre (WBC) 9.7 x 109/L (1.8-157 x 109 /L), periferal monosit sayısı 3.5 x 109/L (1.2-50 x 109/L), trombosit 85 x 109/L (6-992 x 109/L) idi. Splenomegali 11 hastada (%29.7) gözlendi. 14 olguda (%37.8) medyan 11 ay sonra (1-90 ay) AML gelişti ve transformasyon sonrası medyan 11 ay yaşadıkları (1-90 ay) izlendi. OS 12 aydı [MD (miyelodisplastik) tipinde 12 ay, MP (miyeloproliferatif) tipinde 25 ay, p=0.3]. Uluslar arası skorlama sisteminde (IPSS) 13 KMML-MD hastasına uygulanabildi (WBC < 12 x 109/L). Hastalar yayınlanmış skorlama sistemlerine göre yeniden değerlendirildi. Risk grupları arasında anlamlı OS farkı mevcuttu (Modifiye Bournemouth skorunda:p= 0.039, Duesseldorf skorunda:p= 0.01, IPSS: p=0.003). Multivaryant analizi yapıldığında Hb (< 10 g/dL) ve kemik iliği blast yüzdesinin (>=; %10) prognostik anlam taşıdığı görüldü (p= 0.03, p= 0.002). Güncel prognostik skorlama sistemlerinin KMML'de kullanımı cesaret verici olsa da klinikte karar vermede daha spesifik prognostik faktörlere ihtiyaç olduğu kanısındayız.
Main objective of this study was to evaluate hematological, clinical and demographic features of our chronic myelomonocytic leukemia (CMML) patients according to different classification systems and prognostic variables. Thirty-seven consecutive patients with CMML diagnosed between February 1994 and December 2005 were evaluated retrospectively. Male and female ratio was 29/8. The median age at diagnosis was 72. Median follow-up time for all patients was 12 months (1-119 months). 70.3% of patients were classified as CMML-MP, others were classified as CMML-MD type according to FAB. When they were reclassified according to WHO, 86.5% of them were CMML-I and 13.5% were CMML-II. Karyotyping analysis could be made in only 22 patients.
Median laboratory values were as follows: hemoglobin (Hb) 9 g/dL (range 6.1-14 g/dL), white blood cell (WBC) count 9.7 x 109/L (range1.8-157 x 109/L), peripheral monocyte count 3.5 x 109 /L (range 1.2-50 x 109 /L), platelet count 85 x 109/L (range 6-992 x 109 /L). Splenomegaly was observed in 11 patients (29.7%). 14 patients (37.8%) developed AML after a median time of 11 months (1-90 months) and survived a median of 1.5 months after leukemia transformation. The overall survival (OS) was 12 months (MD: 12 months, MP: 25 months, p= 0.3). International Prognostic Scoring Sytem (IPSS) could be applied to only 13 CMML-MD patients (WBC < 12 x 109/L). Patients were also assessed using previously published scoring systems. Significant differencies between risk groups were found in case of OS (Modified Bournemouth score: p= 0.039, Duesseldorf score: p= 0.01, IPSS: p= 0.003). In multivariate analysis, only hemoglobine (< 10 g/dL) and bone marrow blast percentage (>=; 10%) have been found to have a prognostic value (p= 0.03, p= 0.002).
Although use of current prognostic scoring systems is encouraging in CMML more reliable disease spesific prognostic factors are needed for clinical decision making.]]></description><identifier>ISSN: 1306-133X</identifier><language>eng</language><publisher>Akademi Doktorlar Yayınevi</publisher><ispartof>Uluslararası hematologi-onkoloji dergisi, 2008, Vol.18 (4), p.193-200</ispartof><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4024</link.rule.ids></links><search><creatorcontrib>ÖZSAN, Güner H</creatorcontrib><creatorcontrib>ÜNDAR, Bülent</creatorcontrib><creatorcontrib>DEMİRKAN, Fatih</creatorcontrib><creatorcontrib>PİŞKİN, Özden</creatorcontrib><creatorcontrib>ALACACIOĞLU, İnci</creatorcontrib><creatorcontrib>ÖZCAN, Mehmet A</creatorcontrib><title>Prognostic factors and scoring systems in chronic myelomonocytic leukemia: A retrospective analysis of 37 patients</title><title>Uluslararası hematologi-onkoloji dergisi</title><description><![CDATA[Çalışmada kronik myelomonositik lösemili (KMML) olgularımızın farklı sınıflama ve prognostik skorlama sistemlerine göre hematolojik, klinik ve demografik özelliklerini değerlendirmeyi amaçladık.
Şubat 1994 ile Aralık 2005 arası tanı almış 37 KMML hastası retrospektif olarak değerlendirildi. Erkek kadın oranı 29/8, tanı anındaki medyan yaş 72 idi. Hastaların medyan izlem süresi 12 aydı (1-119 ay). Olguların FAB'a göre %70.3'ü KMML-MP, diğerleri KMML-MD olarak sınıflandırıldı. WHO'ya göre, %86.5'i KMML-I, %13.5'i KMMLII olarak yeniden sınıflandırıldı. Karyotipik analiz 22 hastada yapılabildi.
Medyan laboratuar değerlerinden hemoglobin (Hb) 9 g/dL (6.1-14 g/dL), beyaz küre (WBC) 9.7 x 109/L (1.8-157 x 109 /L), periferal monosit sayısı 3.5 x 109/L (1.2-50 x 109/L), trombosit 85 x 109/L (6-992 x 109/L) idi. Splenomegali 11 hastada (%29.7) gözlendi. 14 olguda (%37.8) medyan 11 ay sonra (1-90 ay) AML gelişti ve transformasyon sonrası medyan 11 ay yaşadıkları (1-90 ay) izlendi. OS 12 aydı [MD (miyelodisplastik) tipinde 12 ay, MP (miyeloproliferatif) tipinde 25 ay, p=0.3]. Uluslar arası skorlama sisteminde (IPSS) 13 KMML-MD hastasına uygulanabildi (WBC < 12 x 109/L). Hastalar yayınlanmış skorlama sistemlerine göre yeniden değerlendirildi. Risk grupları arasında anlamlı OS farkı mevcuttu (Modifiye Bournemouth skorunda:p= 0.039, Duesseldorf skorunda:p= 0.01, IPSS: p=0.003). Multivaryant analizi yapıldığında Hb (< 10 g/dL) ve kemik iliği blast yüzdesinin (>=; %10) prognostik anlam taşıdığı görüldü (p= 0.03, p= 0.002). Güncel prognostik skorlama sistemlerinin KMML'de kullanımı cesaret verici olsa da klinikte karar vermede daha spesifik prognostik faktörlere ihtiyaç olduğu kanısındayız.
Main objective of this study was to evaluate hematological, clinical and demographic features of our chronic myelomonocytic leukemia (CMML) patients according to different classification systems and prognostic variables. Thirty-seven consecutive patients with CMML diagnosed between February 1994 and December 2005 were evaluated retrospectively. Male and female ratio was 29/8. The median age at diagnosis was 72. Median follow-up time for all patients was 12 months (1-119 months). 70.3% of patients were classified as CMML-MP, others were classified as CMML-MD type according to FAB. When they were reclassified according to WHO, 86.5% of them were CMML-I and 13.5% were CMML-II. Karyotyping analysis could be made in only 22 patients.
Median laboratory values were as follows: hemoglobin (Hb) 9 g/dL (range 6.1-14 g/dL), white blood cell (WBC) count 9.7 x 109/L (range1.8-157 x 109/L), peripheral monocyte count 3.5 x 109 /L (range 1.2-50 x 109 /L), platelet count 85 x 109/L (range 6-992 x 109 /L). Splenomegaly was observed in 11 patients (29.7%). 14 patients (37.8%) developed AML after a median time of 11 months (1-90 months) and survived a median of 1.5 months after leukemia transformation. The overall survival (OS) was 12 months (MD: 12 months, MP: 25 months, p= 0.3). International Prognostic Scoring Sytem (IPSS) could be applied to only 13 CMML-MD patients (WBC < 12 x 109/L). Patients were also assessed using previously published scoring systems. Significant differencies between risk groups were found in case of OS (Modified Bournemouth score: p= 0.039, Duesseldorf score: p= 0.01, IPSS: p= 0.003). In multivariate analysis, only hemoglobine (< 10 g/dL) and bone marrow blast percentage (>=; 10%) have been found to have a prognostic value (p= 0.03, p= 0.002).
Although use of current prognostic scoring systems is encouraging in CMML more reliable disease spesific prognostic factors are needed for clinical decision making.]]></description><issn>1306-133X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNotjMtKAzEUQLNQsFb_wEV-YCCZmMzEXSm-oKALBXclj5saO0lKbirM31vR1dmcc87IggumOi7ExwW5RPxiTImeqQWpr7XscsEWHQ3GtVKRmuwpulJj3lGcsUFCGjN1n7Xkk5ZmmEoqubj5t5rguIcUzR1d0QqtFjyAa_EbTh8zzRiRlkDFQA-mRcgNr8h5MBPC9T-X5P3h_m391G1eHp_Xq02HfFCtG7XX1mvlenAeuLMycCHl4JmUalRBKq08gyD68dbZ0UIvhOiV5TYYMygmluTm73uczN7GtD3UmEydt7rXkosfi-lWBw</recordid><startdate>2008</startdate><enddate>2008</enddate><creator>ÖZSAN, Güner H</creator><creator>ÜNDAR, Bülent</creator><creator>DEMİRKAN, Fatih</creator><creator>PİŞKİN, Özden</creator><creator>ALACACIOĞLU, İnci</creator><creator>ÖZCAN, Mehmet A</creator><general>Akademi Doktorlar Yayınevi</general><scope>GIY</scope><scope>GIZ</scope><scope>GJA</scope><scope>GJB</scope></search><sort><creationdate>2008</creationdate><title>Prognostic factors and scoring systems in chronic myelomonocytic leukemia: A retrospective analysis of 37 patients</title><author>ÖZSAN, Güner H ; ÜNDAR, Bülent ; DEMİRKAN, Fatih ; PİŞKİN, Özden ; ALACACIOĞLU, İnci ; ÖZCAN, Mehmet A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-s176t-89d9bd96c2ecde1cb5f13557d055686f5696d0ef3284cb8be233326b1bfaa7603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><toplevel>online_resources</toplevel><creatorcontrib>ÖZSAN, Güner H</creatorcontrib><creatorcontrib>ÜNDAR, Bülent</creatorcontrib><creatorcontrib>DEMİRKAN, Fatih</creatorcontrib><creatorcontrib>PİŞKİN, Özden</creatorcontrib><creatorcontrib>ALACACIOĞLU, İnci</creatorcontrib><creatorcontrib>ÖZCAN, Mehmet A</creatorcontrib><collection>ULAKBIM - Mühendislik ve Temel Bilimler Veri Tabani</collection><collection>ULAKBIM - Yaşam Bilimleri Veri Tabani</collection><collection>ULAKBIM - Turk Sosyal Bilimler Veri Tabani</collection><collection>ULAKBIM - Türk Tıp Veri Tabani</collection><jtitle>Uluslararası hematologi-onkoloji dergisi</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ÖZSAN, Güner H</au><au>ÜNDAR, Bülent</au><au>DEMİRKAN, Fatih</au><au>PİŞKİN, Özden</au><au>ALACACIOĞLU, İnci</au><au>ÖZCAN, Mehmet A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic factors and scoring systems in chronic myelomonocytic leukemia: A retrospective analysis of 37 patients</atitle><jtitle>Uluslararası hematologi-onkoloji dergisi</jtitle><date>2008</date><risdate>2008</risdate><volume>18</volume><issue>4</issue><spage>193</spage><epage>200</epage><pages>193-200</pages><issn>1306-133X</issn><abstract><![CDATA[Çalışmada kronik myelomonositik lösemili (KMML) olgularımızın farklı sınıflama ve prognostik skorlama sistemlerine göre hematolojik, klinik ve demografik özelliklerini değerlendirmeyi amaçladık.
Şubat 1994 ile Aralık 2005 arası tanı almış 37 KMML hastası retrospektif olarak değerlendirildi. Erkek kadın oranı 29/8, tanı anındaki medyan yaş 72 idi. Hastaların medyan izlem süresi 12 aydı (1-119 ay). Olguların FAB'a göre %70.3'ü KMML-MP, diğerleri KMML-MD olarak sınıflandırıldı. WHO'ya göre, %86.5'i KMML-I, %13.5'i KMMLII olarak yeniden sınıflandırıldı. Karyotipik analiz 22 hastada yapılabildi.
Medyan laboratuar değerlerinden hemoglobin (Hb) 9 g/dL (6.1-14 g/dL), beyaz küre (WBC) 9.7 x 109/L (1.8-157 x 109 /L), periferal monosit sayısı 3.5 x 109/L (1.2-50 x 109/L), trombosit 85 x 109/L (6-992 x 109/L) idi. Splenomegali 11 hastada (%29.7) gözlendi. 14 olguda (%37.8) medyan 11 ay sonra (1-90 ay) AML gelişti ve transformasyon sonrası medyan 11 ay yaşadıkları (1-90 ay) izlendi. OS 12 aydı [MD (miyelodisplastik) tipinde 12 ay, MP (miyeloproliferatif) tipinde 25 ay, p=0.3]. Uluslar arası skorlama sisteminde (IPSS) 13 KMML-MD hastasına uygulanabildi (WBC < 12 x 109/L). Hastalar yayınlanmış skorlama sistemlerine göre yeniden değerlendirildi. Risk grupları arasında anlamlı OS farkı mevcuttu (Modifiye Bournemouth skorunda:p= 0.039, Duesseldorf skorunda:p= 0.01, IPSS: p=0.003). Multivaryant analizi yapıldığında Hb (< 10 g/dL) ve kemik iliği blast yüzdesinin (>=; %10) prognostik anlam taşıdığı görüldü (p= 0.03, p= 0.002). Güncel prognostik skorlama sistemlerinin KMML'de kullanımı cesaret verici olsa da klinikte karar vermede daha spesifik prognostik faktörlere ihtiyaç olduğu kanısındayız.
Main objective of this study was to evaluate hematological, clinical and demographic features of our chronic myelomonocytic leukemia (CMML) patients according to different classification systems and prognostic variables. Thirty-seven consecutive patients with CMML diagnosed between February 1994 and December 2005 were evaluated retrospectively. Male and female ratio was 29/8. The median age at diagnosis was 72. Median follow-up time for all patients was 12 months (1-119 months). 70.3% of patients were classified as CMML-MP, others were classified as CMML-MD type according to FAB. When they were reclassified according to WHO, 86.5% of them were CMML-I and 13.5% were CMML-II. Karyotyping analysis could be made in only 22 patients.
Median laboratory values were as follows: hemoglobin (Hb) 9 g/dL (range 6.1-14 g/dL), white blood cell (WBC) count 9.7 x 109/L (range1.8-157 x 109/L), peripheral monocyte count 3.5 x 109 /L (range 1.2-50 x 109 /L), platelet count 85 x 109/L (range 6-992 x 109 /L). Splenomegaly was observed in 11 patients (29.7%). 14 patients (37.8%) developed AML after a median time of 11 months (1-90 months) and survived a median of 1.5 months after leukemia transformation. The overall survival (OS) was 12 months (MD: 12 months, MP: 25 months, p= 0.3). International Prognostic Scoring Sytem (IPSS) could be applied to only 13 CMML-MD patients (WBC < 12 x 109/L). Patients were also assessed using previously published scoring systems. Significant differencies between risk groups were found in case of OS (Modified Bournemouth score: p= 0.039, Duesseldorf score: p= 0.01, IPSS: p= 0.003). In multivariate analysis, only hemoglobine (< 10 g/dL) and bone marrow blast percentage (>=; 10%) have been found to have a prognostic value (p= 0.03, p= 0.002).
Although use of current prognostic scoring systems is encouraging in CMML more reliable disease spesific prognostic factors are needed for clinical decision making.]]></abstract><pub>Akademi Doktorlar Yayınevi</pub><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| title | Prognostic factors and scoring systems in chronic myelomonocytic leukemia: A retrospective analysis of 37 patients |
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