Introduction to a review series: the 2016 revision of the WHO classification of tumors of hematopoietic and lymphoid tissues

Cazzola, Mario

doi:10.1182/blood-2016-03-657379

Cited by 134 publications

(111 citation statements)

References 34 publications

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“…This is a retrospective cohort study that included patients with untreated MZL who were treated with immunotherapy, chemotherapy, surgery, or Helicobacter pylori eradication from January 2008 to December 2016 at the Rabin Medical Center, a single tertiary center in Israel. Diagnosis was based on morphological and immunohistochemical examination of the biopsy specimen based on WHO criteria for MZL . Patients were staged by the Ann Arbor staging system .…”

Section: Methodsmentioning

confidence: 99%

FDG PET/CT as a diagnostic and prognostic tool for the evaluation of marginal zone lymphoma

Vaxman

Bernstine

Kleinstern

et al. 2019

Hematological Oncology

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We evaluated the role of 18‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography ([18F] FDG‐PET) with computed tomography (CT) (PET/CT) as a diagnostic and prognostic tool in newly diagnosed marginal zone lymphoma (MZL) patients. This is a retrospective cohort study of patients with newly diagnosed MZL, treated with immunotherapy, chemotherapy regimens, surgery, or Helicobacter pylori eradication between 2008 and 2016 in a single tertiary center. Only patients who had a pretreatment PET/CT (P‐PET/CT) were included. P‐PET/CT, interim (I‐PET/CT), and end‐of‐treatment PET/CT (E‐PET/CT) studies were reviewed. P‐PET/CT results were reported using two methods of evaluation, qualitative and semi quantitative: visual assessment (VAS) and maximal standardized uptake value (SUVmax), and I‐PET and E‐PET results were reported by Deauville 5‐point score (DS) evaluation as well. Avidity of PET/CT was defined as abnormal uptake in any of these methods. The primary outcome was the prognostic role of P‐PET/CT, I‐PET/CT, and E‐PET/CT on progression‐free survival (PFS) and overall survival (OS). Data of 196 patients with MZL were identified, 110 of which had P‐PET/CT and were included in this analysis. Median age was 67 years (range 18‐93). The median follow‐up period was 63 months (range 3‐278). The median OS and PFS for the whole cohort were 63 (interquartile range 39‐85) and 60 (interquartile range 37‐76) months, respectively. The avidity of PET at baseline for the whole cohort was 70% (77/110 patients), for MALT lymphoma, 62.5% (40/64 patients), for NMZL, 76.4% (13/17 patients), and for SMZL, 82.7% (24/29 patients). When adjusted for IPI, sex, and comorbidities, positive E‐PET/CT was associated with reduced PFS with a hazard ratio (HR) of 3.4 (95% CI, 1.27‐9.14, P = 0.02). Positive E‐PET/CT did not correlate with OS. However, there were only three events. P‐PET/CT was not predictive of PFS or OS. Our study demonstrates that above 70% of MZL are FDG avid. Positive E‐PET/CT is a strong prognostic factor for PFS.

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Section: Methodsmentioning

confidence: 99%

FDG PET/CT as a diagnostic and prognostic tool for the evaluation of marginal zone lymphoma

Vaxman

Bernstine

Kleinstern

et al. 2019

Hematological Oncology

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“…The study population consisted of patients with thrombocytopenia confirmed in two independent samples and microscopic analysis, in regular clinical follow-up in the Hemostasis outpatient clinic of University of Campinas, or admitted to the hematology ward of the same institution. The inclusion criteria was a confirmed diagnosis of any of the following: (i) ITP (based on previously established guidelines) 16 ; (ii) bone marrow failure (including aplastic anemia and myelodisplatic syndromes with a platelet count below 150 × 10 9 /L) 17, 18 ; (ii) post-chemotherapy (Ctx) thrombocytopenia (in admitted patients with hematological malignancies) with a platelet count below 150 × 10 9 /L; and (iv) HM, with platelet counts below 150 × 10 9 /L. Diagnosis of HM was established by clinical and laboratory criteria as determined by international guidelines 19–21 .…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias

Ferreira

Colella

Medina

et al. 2017

Sci Rep

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The differential diagnosis of immune (ITP) and hereditary macrothrombocytopenia (HM) is key to patient management. The immature platelet fraction (IPF) represents the subset of circulating platelets with higher RNA content, and has been shown to distinguish hypo- from hyperproliferative thrombocytopenias. Here we evaluated the diagnostic accuracy of IPF in the differential diagnosis between HM and other thrombocytopenias in a population of patients with post-chemotherapy thrombocytopenia (n = 56), bone marrow failure (n = 22), ITP (n = 105) and HM (n = 27). TPO levels were also measured in HM and ITP matched for platelet counts. Platelet counts were similar in all patient groups. Higher IPF values were observed in both ITP (12.3%; 2.4–65.6%) and HM (29.8%; 4.6–65.9%) compared to hypoproliferative thrombocytopenias. IPF values were also higher in HM compared to ITP, yielding a diagnostic accuracy of 0.80 (95%CI 0.70–0.90; P < 0.0001) to distinguish these two conditions. Intra- and inter-assays reproducibility of IPF in HM patients revealed that this is a stable parameter. In conclusion, IPF is increased in HM compared to both ITP and other thrombocytopenias and contributes to the differentiation between ITP and HM. Further studies are warranted to understand the biological rationale of these findings and to its incorporation in diagnostic algorithms of HM.

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“…The WHO diagnostic criteria for classical MPNs have been recently revised 3,19 ; the main features are summarized in Table 1, whereas detailed criteria for the different nosologic entities are reported in Table 2.…”

Section: The 2016 Revision Of the Who Classification Of Classical Mpnsmentioning

confidence: 99%

“…19 The specific nosologic entity is primarily defined on the basis of clinical and pathologic features: for instance, ET is defined as a combination of thrombocytosis and megakaryocytic proliferation, whereas PV is defined as a combination of erythrocytosis, suppressed endogenous erythropoietin production, and panmyelosis. The genetic lesion, for example, JAK2 (V617F), is then used as a marker of clonality, as shown in Tables 1 and 2.…”

Section: Distinguishing Hereditary Disorders Attributable To Germ Linmentioning

confidence: 99%

Diagnosis, risk stratification, and response evaluation in classical myeloproliferative neoplasms

Rumi

Cazzola

2017

Blood

215

216

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Philadelphia-negative classical myeloproliferative neoplasms (MPNs) include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). The 2016 revision of the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues includes new criteria for the diagnosis of these disorders. Somatic mutations in the 3 driver genes, that is, JAK2, CALR, and MPL, represent major diagnostic criteria in combination with hematologic and morphological abnormalities. PV is characterized by erythrocytosis with suppressed endogenous erythropoietin production, bone marrow panmyelosis, and JAK2 mutation. Thrombocytosis, bone marrow megakaryocytic proliferation, and presence of JAK2, CALR, or MPL mutation are the main diagnostic criteria for ET. PMF is characterized by bone marrow megakaryocytic proliferation, reticulin and/or collagen fibrosis, and presence of JAK2, CALR, or MPL mutation. Prefibrotic myelofibrosis represents an early phase of myelofibrosis, and is characterized by granulocytic/megakaryocytic proliferation and lack of reticulin fibrosis in the bone marrow. The genomic landscape of MPNs is more complex than initially thought and involves several mutant genes beyond the 3 drivers. Comutated, myeloid tumor-suppressor genes contribute to phenotypic variability, phenotypic shifts, and progression to more aggressive disorders. Patients with myeloid neoplasms are at variable risk of vascular complications, including arterial or venous thrombosis and bleeding. Current prognostic models are mainly based on clinical and hematologic parameters, but innovative models that include genetic data are being developed for both clinical and trial settings. In perspective, molecular profiling of MPNs might also allow for accurate evaluation and monitoring of response to innovative drugs that target the mutant clone.

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Introduction to a review series: the 2016 revision of the WHO classification of tumors of hematopoietic and lymphoid tissues

Cited by 134 publications

References 34 publications

FDG PET/CT as a diagnostic and prognostic tool for the evaluation of marginal zone lymphoma

FDG PET/CT as a diagnostic and prognostic tool for the evaluation of marginal zone lymphoma

Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias

Diagnosis, risk stratification, and response evaluation in classical myeloproliferative neoplasms

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