What treatment options for CMML2 with no detected mutations ?

Welcome to Connect, @pinch. It looks like your mom was newly diagnosed with CMML. (Chronic myelomonocytic leukemia). This is a type of leukemia where there are too many monocytes (white blood cells) in the blood and often an elevated number of immature white blood cells called blasts. Over time, this overabundance of monocytes and blasts eventually crowds out healthy blood cells causing a steady decline in health. Because this develops slowly, it can take a long time before symptoms appear.

The goal, of course, is to stop the proliferation of the defective cells. From my understanding, Azacitidine (Vidaza) is often one of the first line drugs used to treat CMML (and other blood cancers) with helpful results. It interferes with the growth of cancer cells. There are also other drugs on the market and sometimes it can take a combination of meds to be effective.
However, the only known potential cure for CMML is a BMT. I’m not sure at this time if CAR-T is available to treat CMML. I had AML and CAR-T wasn’t an option because of the complexity of the disease and tends to be used more towards treating lymphomas and MM.

You’re concerned that this Vidaza might not work for your mom. She hasn’t even had her first round of chemo yet, so it’s too soon to have those worries. Her doctor will monitor her blood and use the results to adjust her treatment plan.

There are several members in Connect who also have CMML who might be able to offer some input. Here is a link to one of the discussions where you’ll meet @encb27 whose mother was taking Vidaza for CMML and other members @encb27 @miketllc3 who have taken Vidaza.

Side effects of Vidaza injections
https://connect.mayoclinic.org/discussion/side-effects-of-vidaza-injections/
You can find more discussions on Vidaza, Azacitidine and CMML by typing in any one of those words in the upper search bar. You’ll be able to sort through the conversations for the most relevant.

A note about the Azacitidine… It’s a chemo med that kills fast growing cancer cells. Unfortunately it can’t differentiate between cancer and other fast growing cells such as blood cells. So it may also deplete her blood numbers by mid-month. She could have some days of fatigue that may leave her feeling a little weaker. Does she live alone?

Lori always has a wealth of knowledge to share with us when we are first diagnosed and exasperated with understanding the disease. We are lucky to have her.
I am 76 and I was at first diagnosed 8 yrs ago with MDS. Low risk. Wait and see approach. The last year my white cells went up to 40 after one of my blood tests and my doctor ordered a bone marrow biopsy. Ended up having to do another one to get a better specimen to be sent to pathology at one of the big hospitals. It came back that I had CMML with blasts and borderline AML. My doctor put me on 100mg if hydroxy. After 3 weeks my white cells went down to 20. Then the next blood test 3 weeks later my white cells were normal but my red cells dropped so
She stopped. The last test I did was A month ago and it was normal. I am due for another test in 6 weeks.
My oncologist was surprised. I was supposed to have to
Start treatments once my white cells came down. But the hydroxy so far has done the job. Time will tell. My counts were all very good. So you see having CMML has it’s ups and downs I guess. However like Lori said there are many different treatments and combination of treatments they can always try. There is no cure but you can live a good life if the treatments work for you. It’s a bit of a roller coaster ride. I have my faith and turned it all over to God. Good luck and God bless you.

@pinch, welcome. Have you started treatment with azacitidine (Vidaza)? How is it going so far?