Machherndl-Spandl S, Jäger E, Barna A, et al. - Researchers intended to understand potential differences between younger and older chronic myelomonocytic leukaemia (CMML) patients regarding the cumulative risk of transformation as well as haematological, molecular and biologic features. They used the Austrian Biodatabase for CMML, and identified 518 CMML patients. Participants were split into 3 age-related groups: <60 years, 60-79 years and ≥80 years. Per competing risk analysis, a significantly lower risk of transformation was evident at higher age, with a 4-year risk of 39%, 23% and 13%, respectively, in these age groups. A lower percentage of blast cells in the peripheral blood (PB) of older patients was detected in relation to lower likelihood of transformation. In addition, a simple score based on age, PB blasts and platelet counts was created that enabled experts to describe subgroups of CMML cases with a different cumulative transformation risk, including a low-risk group with a transformation risk of only 5%. Overall, reasonable therapeutic decisions in elderly CMML patients may be facilitated by these data.