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WHO 2008 Overview of the classification of the myeloid neoplasms

WHO 2008 Overview of the classification of the myeloid neoplasms. -Myeloproliferative neoplasms -Myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1 - Myelodysplastic/myeloproliferative neoplasms -Myelodysplastic syndromes

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WHO 2008 Overview of the classification of the myeloid neoplasms

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  1. WHO 2008 Overview of the classification of the myeloid neoplasms • -Myeloproliferative neoplasms • -Myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1 • -Myelodysplastic/myeloproliferative neoplasms • -Myelodysplastic syndromes • -Acute myeloid leukaemia (AML) and related precursor neoplasms • -Acute leukaemias of ambiguous lineage • -

  2. WHO 2001 WHO 2008 AML

  3. WHO 2001 > 20% blasten in beenmerg of bloed Promonocyten worden bij de blasten gerekend uitzondering AML met t(8;21), inv(16),t(16;16) of t(15;17): AML onafhankelijk van blasten % WHO 2008 > 20% blasten in beenmerg of bloed Promonocyten worden bij de blasten gerekend uitzondering AML met t(8;21), inv(16),t(16;16) of t(15;17): AML onafhankelijk van blasten %

  4. WHO 2001 -AML with recurrent cytogenetic abnormalities -AML with multilineage dysplasia -AML and MDS therapy related -AML not otherwise categorized -Acute leukemias of ambiguous lineage WHO 2008 -AML with recurrent genetic abnormalities -AML with myelodysplasia related changes -Therapy related myeloid neoplasms -AML not otherwise specified (NOS) -Myeloid sarcoma -Myeloid proliferations related to Down syndrome -Blastic plasmacytoids dendritic cell neoplasms Samenvatting AML classificaties WHO 2001 en WHO 2008

  5. WHO 2001 AML with recurrent cytogenetic abnormalities t(8;21)(q22;q22) AML1/ETO inv(16)(p13.1q22) of t(16;16)(p13q22);CBFB-MYH11 t(15;17) (q22;q12);PML-RARA 11q23 (MLL) abnormalities WHO 2008 AML with recurrent genetic abnormalities t(8;21)(q22;q22) RUNX1-RUNX1T1 inv(16)(p13.1q22) of t(16;16)(p13.1q22);CBFB-MYH11 t(15;17) (q22;q12);PML-RARA t(9;11)(p22;q23);MLLT3-MLL t(6;9)(p23;q34);DEK-NUP214 inv(3) of t(3;3);RPMN1-EVI1 t(1;22)(p13;q13) RBM15-MKL1 mutated NPM1 mutated CEBPA

  6. WHO 2001 AML with multilineage dysplasia > 50% dysplasie in 2 of 3 cellijnen Eventueel na gedocumenteerde MDS WHO 2008 AML with myelodysplasia-related changes Voorafgaande gedocumenteerde MDS of MDS/MPN of MDS gerelateerde cytogenetische afwijking Complex kayotype: >3 unrelated abnormalities Unbalanced abnormalities zoals bijv. –7/del(7q) en –5/(del5q) Balanced abnormalities bijv. t(2;11) Zie blz. 125 WHO 2008 of Multilineage dysplasia (> 50% in 2 of 3 cellijnen) Geen voorafgaande cytotoxische therapie Geen t(8;21) inv(16) of t(15;17)

  7. WHO 2001 AML and MDS, therapy related WHO 2008 Therapy-related myeloid neoplasms t-AML t-MDS t-MDS/MPN

  8. WHO 2001 AML not otherwise categorised AML, minimally differentiated AML without maturation AML with maturation Acute myelomonocytic leukemia Acute monoblastic and monocytic leukemia Acute erythroid leukemia Acute megakaryoblastic leukemia Acute basophilic leukemia Acute panmyelosis with myelofibrosis Myeloid sarcoma WHO 2008 Acute myeloid leukemia, not otherwise specified AML, NOS AML, minimally differentiated AML without maturation AML with maturation Acute myelomonocytic leukemia Acute monoblastic and monocytic leukemia Acute erythroid leukemia Acute megakaryoblastic leukemia Acute basophilic leukemia Acute panmyelosis with myelofibrosis

  9. Acute eryhtroid leukemia • Indien > 50% erythroblasten in het beenmerg, dan wordt het percentage myeloblasten berekend over de NEC • (= non-erythroid cells= granulocytaire cellen). • Myeloblasten als % berekend van de granulocytaire lijn, • indien > 20: AML, erythroleukemia (erythroid/myeloid)

  10. WHO 2008 Myeloid sarcoma

  11. WHO 2008 Myeloid proliferations related to Down syndrome Transient abnormal myelopoiesis Myeloid leukemia associated with Down syndrome

  12. WHO 2008 Blastic plasmacytoid dendritic cell neoplasm Vroeger: Blastic NK-cell leukemia Geassocieerd met MDS

  13. WHO 2001 Acute leukemias of ambiguous lineage Undifferentiated acute leukemia hooguit 1 lijn specifieke marker Bilineal acute leukemia 2 populaties Biphenotypic acute leukemia co-expressie myeloid / B / T merkers EGIL scoring system

  14. EGIL criteria BAL > 2punten voor 2 differentiatielijnen

  15. WHO 2008 Acute leukemias of ambiguous lineage Acute undifferentiated leukemia Mixed phenotype acute leukemia with t(9;22)(q34;q11.2);BCR;ABL Mixed phenotype acute leukemia with t(v;11q23); MLL rearranged Mixed phenotype acute leukemia, B/myeloid, NOS Mixed phenotype acute leukemia, T/myeloid, NOS Mixed phenotype acute leukemia, NOS-rare types Other ambiguous lineage leukemias

  16. WHO 2008: • EGIL scoring system wordt niet meer gebruikt

  17. MPAL: meer dan 2 lijnen

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