Acute lymphoblastic leukemia classification: Difference between revisions
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{{CMG}} {{AE}} {{RT}} | {{CMG}} {{AE}} {{RT}} | ||
== Overview == | == Overview == | ||
Acute | |||
The classification subtyping of the various forms of Acute limphocytic leukemia used to be done according to the [[French-American-British classification|French-American-British (FAB) classification]], which was used for all Acute leukemias (including [[acute myelogenous leukemia]]). As Acute lymphoblastic leukemia is not a solid tumour, the [[TNM|TxNxMx]] notation as used in solid cancers only. The recent World Health Organization International panel on Acute lymphoblastic leukemia recommends that this classification be abandoned, since the morphological classification has no clinical or prognostic relevance. But here you can find both classifications for academic and historic porpouses. | |||
== Classification == | == Classification == | ||
===French-American-British classification=== | ===French-American-British classification=== | ||
The [[French-American-British classification | French-American-British (FAB) classification]] | The [[French-American-British classification | French-American-British (FAB) classification]] system is divided into 3 subtypes L1 to L3 based on the type of cell from which the leukemia developed and its degree of maturity and morphological classification. | ||
* ALL-L1: small uniform cells | * ALL-L1: small uniform cells | ||
* ALL-L2: large varied cells | * ALL-L2: large varied cells | ||
* ALL-L3: large varied cells with [[vacuole]]s (bubble-like features) | * ALL-L3: large varied cells with [[vacuole]]s (bubble-like features) | ||
Note: Each subtype is then further classified by determining the surface markers of the abnormal lymphocytes, called immunophenotyping. There are 2 main immunologic types: pre-B cell and pre-T cell. The mature B-cell Acute lymphoblastic leukemia (L3) is now classified as Burkitt leukemia/lymphoma. Subtyping helps determine the prognosis and most appropriate treatment in treating Acute lymphoblastic leukemia. | |||
===World Health Organization classification === | ===World Health Organization classification === | ||
The [[World Health Organization]] (WHO) classification of | The [[World Health Organization]] (WHO) classification of Acute lymphoblastic leukemia attempts to be more clinically useful and to produce more meaningful prognostic information than the FAB criteria. There are 3 different grups of Lymphoblastic leukemias according to the WHO including a classification with recurrent genetic abnormalities. | ||
===Group 1=== | ===Group 1=== | ||
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:*B lymphoblastic leukemia/lymphoma with t(9;22)(q34;q11.2), ''BCR-ABL1'' | :*B lymphoblastic leukemia/lymphoma with t(9;22)(q34;q11.2), ''BCR-ABL1'' | ||
:*B lymphoblastic leukemia/lymphoma with t(v;11q23); MLL rearranged | :*B lymphoblastic leukemia/lymphoma with t(v;11q23); MLL rearranged | ||
:*B lymphoblastic leukemia/lymphoma with t(12;21)(p13;q22) | :*B lymphoblastic leukemia/lymphoma with t(12;21)(p13;q22) TEL-AML1 (ETV6-RUNX1) | ||
:*B lymphoblastic leukemia/lymphoma with hyperdiploidy | :*B lymphoblastic leukemia/lymphoma with hyperdiploidy | ||
:*B lymphoblastic leukemia/lymphoma with hypodiploidy | :*B lymphoblastic leukemia/lymphoma with hypodiploidy | ||
:*B lymphoblastic leukemia/lymphoma with t(5;14)(q31;q32) | :*B lymphoblastic leukemia/lymphoma with t(5;14)(q31;q32) IL3-IGH | ||
:*B lymphoblastic leukemia/lymphoma with t(1;19)(q23;p13.3) | :*B lymphoblastic leukemia/lymphoma with t(1;19)(q23;p13.3) TCF3-PBX1 | ||
(Images shown below are courtesy of Melih Aktan MD, Istanbul Medical Faculty - Turkey, and Kyoto University - Japan) | (Images shown below are courtesy of Melih Aktan MD, Istanbul Medical Faculty - Turkey, and Kyoto University - Japan) | ||
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{| align="center" | {| align="center" | ||
|-valign="top" | |-valign="top" | ||
| [[Image:ALL-L1 | | [[Image:ALL-L1.jpg|thumb|ALL-L1]] | ||
| [[Image:ALL-L1 | | [[Image:ALL-L1 0002.jpg|thumb|ALL-L1]] | ||
|} | |} | ||
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{| align="center" | {| align="center" | ||
|-valign="top" | |-valign="top" | ||
| [[Image:ALL-L2 | | [[Image:ALL-L2 Hand mirror cell 0001.jpg|thumb|ALL-L2 Hand mirror cell]] | ||
| [[Image:ALL-L2 | | [[Image:ALL-L2 0003.jpg|thumb|ALL-L2]] | ||
|} | |} | ||
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{| align="center" | {| align="center" | ||
|-valign="top" | |-valign="top" | ||
| [[Image:ALL-L2 | | [[Image:ALL-L2 0002.jpg|thumb|ALL-L2]] | ||
| [[Image:ALL-L3 | | [[Image:ALL-L3 0001.jpg|thumb|ALL-L3]] | ||
|} | |} | ||
Revision as of 14:19, 28 August 2015
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Acute lymphoblastic leukemia Microchapters |
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Differentiating Acute lymphoblastic leukemia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Acute lymphoblastic leukemia classification On the Web |
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American Roentgen Ray Society Images of Acute lymphoblastic leukemia classification |
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Directions to Hospitals Treating Acute lymphoblastic leukemia |
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Risk calculators and risk factors for Acute lymphoblastic 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
The classification subtyping of the various forms of Acute limphocytic leukemia used to be done according to the French-American-British (FAB) classification, which was used for all Acute leukemias (including acute myelogenous leukemia). As Acute lymphoblastic leukemia is not a solid tumour, the TxNxMx notation as used in solid cancers only. The recent World Health Organization International panel on Acute lymphoblastic leukemia recommends that this classification be abandoned, since the morphological classification has no clinical or prognostic relevance. But here you can find both classifications for academic and historic porpouses.
Classification
French-American-British classification
The French-American-British (FAB) classification system is divided into 3 subtypes L1 to L3 based on the type of cell from which the leukemia developed and its degree of maturity and morphological classification.
- ALL-L1: small uniform cells
- ALL-L2: large varied cells
- ALL-L3: large varied cells with vacuoles (bubble-like features)
Note: Each subtype is then further classified by determining the surface markers of the abnormal lymphocytes, called immunophenotyping. There are 2 main immunologic types: pre-B cell and pre-T cell. The mature B-cell Acute lymphoblastic leukemia (L3) is now classified as Burkitt leukemia/lymphoma. Subtyping helps determine the prognosis and most appropriate treatment in treating Acute lymphoblastic leukemia.
World Health Organization classification
The World Health Organization (WHO) classification of Acute lymphoblastic leukemia attempts to be more clinically useful and to produce more meaningful prognostic information than the FAB criteria. There are 3 different grups of Lymphoblastic leukemias according to the WHO including a classification with recurrent genetic abnormalities.
Group 1
- B lymphoblastic leukemia/lymphoma
Group 2
- B lymphoblastic leukemia/lymphoma (Not organ specific)
Group 3
- B lymphoblastic leukemia/lymphoma with recurrent genetic abnormalities:
- B lymphoblastic leukemia/lymphoma with t(9;22)(q34;q11.2), BCR-ABL1
- B lymphoblastic leukemia/lymphoma with t(v;11q23); MLL rearranged
- B lymphoblastic leukemia/lymphoma with t(12;21)(p13;q22) TEL-AML1 (ETV6-RUNX1)
- B lymphoblastic leukemia/lymphoma with hyperdiploidy
- B lymphoblastic leukemia/lymphoma with hypodiploidy
- B lymphoblastic leukemia/lymphoma with t(5;14)(q31;q32) IL3-IGH
- B lymphoblastic leukemia/lymphoma with t(1;19)(q23;p13.3) TCF3-PBX1
(Images shown below are courtesy of Melih Aktan MD, Istanbul Medical Faculty - Turkey, and Kyoto University - Japan)
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