Acute myeloid leukemia classification: Difference between revisions

Jump to navigation Jump to search
Line 72: Line 72:


The WHO subtypes of AML are:<ref>{{cite journal | author = Vardiman J, Harris N, Brunning R | title = The World Health Organization (WHO) classification of the myeloid neoplasms | journal = Blood | volume = 100 | issue = 7 | pages = 2292-302 | year = 2002 | pmid = 12239137}}'' [http://www.bloodjournal.org/cgi/content/full/100/7/2292 Full text]''.</ref>
The WHO subtypes of AML are:<ref>{{cite journal | author = Vardiman J, Harris N, Brunning R | title = The World Health Organization (WHO) classification of the myeloid neoplasms | journal = Blood | volume = 100 | issue = 7 | pages = 2292-302 | year = 2002 | pmid = 12239137}}'' [http://www.bloodjournal.org/cgi/content/full/100/7/2292 Full text]''.</ref>
* '''AML with characteristic genetic abnormalities''', which includes AML with translocations between chromosome 8 and 21 &#91;t(8;21)&#93;, inversions in chromosome 16 &#91;inv(16)&#93;, or translocations between chromosome 15 and 17 &#91;t(15;17)&#93;. Patients with AML in this category generally have a high rate of remission and a better prognosis compared to other types of AML.
* '''AML with multilineage dysplasia'''. This category includes patients who have had a prior [[myelodysplastic syndrome]] (MDS) or [[myeloproliferative disease]] (MPD) that transforms into AML. This category of AML occurs most often in elderly patients and often has a worse prognosis.
* '''AML and MDS, therapy-related'''. This category includes patients who have had prior chemotherapy and/or radiation and subsequently develop AML or MDS. These leukemias may be characterized by specific chromosomal abnormalities, and often carry a worse prognosis.
* '''AML not otherwise categorized'''. Includes subtypes of AML that do not fall into the above categories.
* '''Acute leukemias of ambiguous lineage'''. Acute leukemias of ambiguous lineage (also known as mixed phenotype or biphenotypic acute leukemia) occur when the leukemic cells can not be classified as either myeloid or lymphoid cells, or where both types of cells are present.


{| class="wikitable"
|-
! Name
! Description
! [[ICD-O]]
|-
| '''AML with characteristic genetic abnormalities'''
| Includes:


* AML with translocations between [[chromosome 8]] and 21 &#91;t(8;21)&#93; (ICD-O 9896/3); [[RUNX1]]/[[RUNX1T1]]
* AML with inversions in [[chromosome 16]] &#91;inv(16)&#93; (ICD-O 9871/3); [[CBFB]]/[[MYH11]]
* APL with translocations between [[chromosome 15]] and 17 &#91;t(15;17)&#93; (ICD-O 9866/3); [[Retinoic acid receptor alpha|RARA]];[[Promyelocytic leukemia protein|PML]]
Patients with AML in this category generally have a high rate of remission and a better prognosis compared to other types of AML.
| Multiple
|-
| '''AML with multilineage dysplasia'''
| This category includes patients who have had a prior [[myelodysplastic syndrome]] (MDS) or [[myeloproliferative disease]] (MPD) that transforms into AML. This category of AML occurs most often in elderly patients and often has a worse prognosis.
| {{ICDO|9895|3}}
|-
| '''AML and MDS, therapy-related'''
| This category includes patients who have had prior chemotherapy and/or radiation and subsequently develop AML or MDS. These leukemias may be characterized by specific chromosomal abnormalities, and often carry a worse prognosis.
| {{ICDO|9920|3}}
|-
| '''AML not otherwise categorized'''
| Includes subtypes of AML that do not fall into the above categories.
| {{ICDO|9861|3}}
|}
Acute leukemias of ambiguous lineage (also known as mixed phenotype or [[biphenotypic acute leukemia]]) occur when the leukemic cells can not be classified as either myeloid or lymphoid cells, or where both types of cells are present.


==References==
==References==

Revision as of 14:13, 8 August 2012

Acute myeloid leukemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Acute myeloid leukemia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardigram

Chest X Ray

Echocardiograph and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Acute myeloid leukemia classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Acute myeloid leukemia classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Acute myeloid leukemia classification

CDC on Acute myeloid leukemia classification

Acute myeloid leukemia classification in the news

Blogs on Acute myeloid leukemia classification

Directions to Hospitals Treating Acute myeloid leukemia

Risk calculators and risk factors for Acute myeloid leukemia classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Overview

Classification

The two most commonly used classification schemata for AML, as of 2006, are the older French-American-British (FAB) system and the newer World Health Organization (WHO) system.

French-American-British classification

The French-American-British (FAB) classification system divided AML into 8 subtypes, M0 through to M7, based on the type of cell from which the leukemia developed and its degree of maturity. This is done by examining the appearance of the malignant cells under light microscopy and/or by using cytogenetics to characterize any underlying chromosomal abnormalities. The subtypes have varying prognoses and responses to therapy. Although the WHO classification (see below) may be more useful, the FAB system is still widely used as of mid-2006.

The eight FAB subtypes are:[1]

Type Name Cytogenetics Percentage of adult AML patients
M0 Minimally differentiated AML 5%
M1 Acute myeloblastic leukemia, without maturation 15%
M2 Acute myeloblastic leukemia, with granulocytic maturation t(8;21)(q22;q22), t(6;9) 25%
M3 Promyelocytic, or Acute promyelocytic leukemia (APL) t(15;17) 10%
M4 Acute myelomonocytic leukemia inv(16)(p13q22), del(16q) 20%
M4eo Myelomonocytic together with bone marrow eosinophilia inv(16), t(16;16) 5%
M5 Acute monoblastic leukemia (M5a) or Acute monocytic leukemia (M5b) del (11q), t(9;11), t(11;19) 10%
M6 Acute erythroid leukemias, including erythroleukemia (M6a) and very rare pure erythroid leukemia (M6b) 5%
M7 Acute megakaryoblastic leukemia t(1;22) 5%

World Health Organization classification

The World Health Organization (WHO) classification of acute myeloid leukemia attempts to be more clinically useful and to produce more meaningful prognostic information than the FAB criteria. Each of the WHO categories contains numerous descriptive sub-categories of interest to the hematopathologist and oncologist; however, most of the clinically significant information in the WHO schema is communicated via categorization into one of the five subtypes listed below.

The WHO subtypes of AML are:[2]

Name Description ICD-O
AML with characteristic genetic abnormalities Includes:

Patients with AML in this category generally have a high rate of remission and a better prognosis compared to other types of AML.

Multiple
AML with multilineage dysplasia This category includes patients who have had a prior myelodysplastic syndrome (MDS) or myeloproliferative disease (MPD) that transforms into AML. This category of AML occurs most often in elderly patients and often has a worse prognosis. Template:ICDO
AML and MDS, therapy-related This category includes patients who have had prior chemotherapy and/or radiation and subsequently develop AML or MDS. These leukemias may be characterized by specific chromosomal abnormalities, and often carry a worse prognosis. Template:ICDO
AML not otherwise categorized Includes subtypes of AML that do not fall into the above categories. Template:ICDO

Acute leukemias of ambiguous lineage (also known as mixed phenotype or biphenotypic acute leukemia) occur when the leukemic cells can not be classified as either myeloid or lymphoid cells, or where both types of cells are present.

References

  1. Bennett J, Catovsky D, Daniel M, Flandrin G, Galton D, Gralnick H, Sultan C (1976). "Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group". Br J Haematol. 33 (4): 451–8. PMID 188440.
  2. Vardiman J, Harris N, Brunning R (2002). "The World Health Organization (WHO) classification of the myeloid neoplasms". Blood. 100 (7): 2292–302. PMID 12239137. Full text.

Template:Hematology



Template:WikiDoc Sources