The new diagnostic criteria for myelodysplasia-related acute myeloid leukemia is useful for predicting clinical outcome: comparison of the 4th and 5th World Health Organization classifications

Park, Hee Sue; Kim, Hee Kyung; Kim, Hong-sik; Yang, Yaewon; Han, Hye Sook; Lee, Ki Hyeong; Son, Bo Ra; Kwon, Jihyun

doi:10.1007/s00277-022-05002-7

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…The definition, classification, and diagnostic criteria in many categories of myeloid neoplasms have been updated in WHO-5 and ICC, because of our understanding of morphology and molecular genetic changes. There have been a few comparison studies using the WHO classification, which support the newly updated categorization [62,63]. ICC for acute leukemia has been adopted in the new European LeukemiaNet (ELN) guidelines [2].…”

Section: Discussionmentioning

confidence: 99%

The fifth edition of the World Health Organization Classification and the International Consensus Classification of myeloid neoplasms: evolving guidelines in the molecular era with practical implications

Zheng

Zhang

Pan

2022

Current Opinion in Hematology

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Purpose of reviewThere have been major advances in our understanding of molecular pathogenesis of myeloid neoplasms, which prompt the updates in the classification of myeloid neoplasms in the fifth edition of World Health Organization Classification (WHO-5) and the new International Consensus Classification (ICC). The purpose of this review is to provide an overview of these two classification systems for myeloid neoplasms.Recent findingsThe definition, classification, and diagnostic criteria in many myeloid entities have been refined in WHO-5 and ICC with improved understanding of morphology and integration of new genetic findings. Particularly, molecular and cytogenetic studies have been increasingly incorporated into the classification, risk stratification, and selection of therapy of myeloid neoplasms. Overall, despite some revisions and discrepancies between WHO-5 and ICC, the major categories of myeloid neoplasms remain the same. Further validation studies are warranted to fine-tune and, ideally, integrate these two classifications.SummaryIntegration of clinical information, laboratory parameters, morphologic features, and cytogenetic and molecular studies is essential for the classification of myeloid neoplasms, as recommended by both WHO-5 and ICC.

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Section: Discussionmentioning

confidence: 99%

The fifth edition of the World Health Organization Classification and the International Consensus Classification of myeloid neoplasms: evolving guidelines in the molecular era with practical implications

Zheng

Zhang

Pan

2022

Current Opinion in Hematology

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Section: Molecular Signaturementioning

confidence: 99%

“…According to the findings of Park et al, KRAS mutations confer significantly inferior survival rates compared with mutations in other genes (median OS was 0.4 vs. 6.5 months, p = 0.007) [ 79 ]. Moreover, NRAS mutations co-occur with other gene mutations, such as KRAS and CEBPA ( p = 0.012; and p = 0.049, respectively) [ 79 ]. The study performed by Badar et al indicated that the acquisition of detectable levels of RAS and/or FLT3 -ITD gene mutation at the moment of MDS transformation to AML resulted in approximately 30% of cases and predicted extremely poor outcomes [ 24 ].…”

Section: Molecular Signaturementioning

confidence: 99%

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The Genetic Landscape of Myelodysplastic Neoplasm Progression to Acute Myeloid Leukemia

Bănescu

Tripon

Muntean

2023

IJMS

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Myelodysplastic neoplasm (MDS) represents a heterogeneous group of myeloid disorders that originate from the hematopoietic stem and progenitor cells that lead to the development of clonal hematopoiesis. MDS was characterized by an increased risk of transformation into acute myeloid leukemia (AML). In recent years, with the aid of next-generation sequencing (NGS), an increasing number of molecular aberrations were discovered, such as recurrent mutations in FLT3, NPM1, DNMT3A, TP53, NRAS, and RUNX1 genes. During MDS progression to leukemia, the order of gene mutation acquisition is not random and is important when considering the prognostic impact. Moreover, the co-occurrence of certain gene mutations is not random; some of the combinations of gene mutations seem to have a high frequency (ASXL1 and U2AF1), while the co-occurrence of mutations in splicing factor genes is rarely observed. Recent progress in the understanding of molecular events has led to MDS transformation into AML and unraveling the genetic signature has paved the way for developing novel targeted and personalized treatments. This article reviews the genetic abnormalities that increase the risk of MDS transformation to AML, and the impact of genetic changes on evolution. Selected therapies for MDS and MDS progression to AML are also discussed.

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Acute myeloid leukemia and myelodysplastic neoplasms: clinical implications of myelodysplasia-related genes mutations and TP53 aberrations

Kim,

Lee,

et al. 2024

Blood Res.

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Purpose The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. In this study, patients were reclassified according to the revised classification and their prognoses were analyzed to confirm the clinical utility of the new classifications. Methods We included 101 adult patients, 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified the patients according to the revised criteria, examined the differences, and analyzed the prognosis using survival analysis. Results According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than that of patients in other AML groups; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months). Conclusion The revised classifications allow for a more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown a high prognostic significance in a small number of cases.

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The new diagnostic criteria for myelodysplasia-related acute myeloid leukemia is useful for predicting clinical outcome: comparison of the 4th and 5th World Health Organization classifications

Cited by 5 publications

References 20 publications

The fifth edition of the World Health Organization Classification and the International Consensus Classification of myeloid neoplasms: evolving guidelines in the molecular era with practical implications

The fifth edition of the World Health Organization Classification and the International Consensus Classification of myeloid neoplasms: evolving guidelines in the molecular era with practical implications

The Genetic Landscape of Myelodysplastic Neoplasm Progression to Acute Myeloid Leukemia

Acute myeloid leukemia and myelodysplastic neoplasms: clinical implications of myelodysplasia-related genes mutations and TP53 aberrations

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