Reclassification of Acute Myeloid Leukemia According to the 2016 WHO Classification
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초록
We reviewed our leukemia database to reclassify 610 patients previously diagnosed as having acute myeloid leukemia (AML) according to the updated 2016 WHO classification. Nine patients were categorized as having myelodysplastic syndrome and myeloid neoplasms with germline predisposition. AML with recurrent genetic abnormalities accounted for 57.4% (345/601) of the patients under the 2016 WHO classification. AML with mutated NPM1 was the most common form (16.5%), with the majority associated with monocytic differentiation (63.6%). AML with double CEBPA mutations accounted for 8.3% of these cases, and the majority were previously diagnosed as AML with/without maturation (78.0%). These newly classified mutations were mutually exclusive without overlapping with other forms of AML with recurrent genetic abnormalities. AML with mutated NPM1 and AML with myelodysplasia-related changes comprised the oldest patients, whereas AML with RUNX1-RUNX1T1 included the youngest patients. The leukocyte count was highest in AML with mutated NPM1, and the percentage of peripheral blood blasts was the highest in AML with double CEBPA mutations. Our results indicate that implementation of the 2016 WHO classification of AML would not pose major difficulties in clinical practice. Hematopathologists should review and prepare genetic tests for the new classification, according to their clinical laboratory conditions.
Abstract
We reviewed our leukemia database to reclassify 610 patients previously diagnosed as having acute myeloid leukemia (AML) according to the updated 2016 WHO classification. Nine patients were categorized as having myelodysplastic syndrome and myeloid neoplasms with germline predisposition. AML with recurrent genetic abnormalities accounted for 57.4% (345/601) of the patients under the 2016 WHO classification. AML with mutated NPM1 was the most common form (16.5%), with the majority associated with monocytic differentiation (63.6%). AML with double CEBPA mutations accounted for 8.3% of these cases, and the majority were previously diagnosed as AML with/without maturation (78.0%). These newly classified mutations were mutually exclusive without overlapping with other forms of AML with recurrent genetic abnormalities. AML with mutated NPM1 and AML with myelodysplasia-related changes comprised the oldest patients, whereas AML with RUNX1-RUNX1T1 included the youngest patients. The leukocyte count was highest in AML with mutated NPM1, and the percentage of peripheral blood blasts was the highest in AML with double CEBPA mutations. Our results indicate that implementation of the 2016 WHO classification of AML would not pose major difficulties in clinical practice. Hematopathologists should review and prepare genetic tests for the new classification, according to their clinical laboratory conditions.
참고문헌 (13)
- Vardiman JW, "The 2008 revision of the World Health Organization(WHO)classification of myeloid neoplasms and acute leukemia : rationale and important changes", Blood, 114, pp.937~951 (2009)
- Arber DA, "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia", Blood, 127, pp.2391~2405 (2016)
- McGowan-Jordan J, "ISCN 2016: an international system for human cytogenomic nomenclature", pp.7~99 (2016), Karger
- Döhner K, "Mutant nucleophosmin(NPM1)predicts favorable prognosis in younger adults with acute myeloid leukemia and normal cytogenetics : interaction with other gene mutations", Blood, 106, pp.3740~3746 (2005)
- Falini B, "Acute myeloid leukemia with mutated NPM1 : diagnosis, prognosis and therapeutic perspectives", Curr Opin Oncol, 21, pp.573~581 (2009)
- Haferlach C, "AML with mutated NPM1 carrying a normal or aberrant karyotype show overlapping biologic, pathologic, immunophenotypic, and prognostic features", Blood, 114, pp.3024~3032 (2009)
- Lin LI, "Characterization of CEBPA mutations in acute myeloid leukemia : most patients with CEBPA mutations have biallelic mutations and show a distinct immunophenotype of the leukemic cells", Clin Cancer Res, 11, pp.1372~1379 (2005)
- Ho PA, "Prevalence and prognostic implications of CEBPA mutations in pediatric acute myeloid leukemia(AML) : a report from the Children’s Oncology Group", Blood, 113, pp.6558~6566 (2009)
- Li HY, "Favorable prognosis of biallelic CEBPA gene mutations in acute myeloid leukemia patients : a meta-analysis", Eur J Haematol, 94, pp.439~448 (2015)
- Grossmann V, "CEBPA double-mutated acute myeloid leukaemia harbours concomitant molecular mutations in 76.8% of cases with TET2 and GATA2 alterations impacting prognosis", Br J Haematol, 161, pp.649~658 (2013)
- Dufour A, "Acute myeloid leukemia with biallelic CEBPA gene mutations and normal karyotype represents a distinct genetic entity associated with a favorable clinical outcome", J Clin Oncol, 28, pp.570~577 (2010)
- Salipante SJ, "Detection of minimal residual disease in NPM1-mutated acute myeloid leukemia by next-generation sequencing", Mod Pathol, 27, pp.1438~1446 (2014)
- Behdad A, "A clinical grade sequencing-based assay for CEBPA mutation testing : report of a large series of myeloid neoplasms", J Mol Diagn, 17, pp.76~84 (2015)