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Leukemia - Acute

AML

Classification


Reviewer: Syed Zaidi, M.D. (see Reviewers page)
Revised: 27 December 2011, last major update December 2011
Copyright: (c) 2001-2011, PathologyOutlines.com, Inc.

Definition
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● French-American-British (FAB) classification system was used from 1976 to 2001, divided AML into M0-M7 (Br J Haematol 1976;33:451)
● WHO classification (2001 and revised in 2008) requires minimium of 20% of blasts in bone marrow or blood to diagnose AML (was 30% under FAB), which eliminates myelodysplastic category of “refractory anemia with excess blasts in transformation” (Blood 2002;100:2292)
● WHO classification also separates out AML “with recurrent genetic abnormalities”, which have distinct clinical features

Acute myeloid leukemias with recurrent genetic abnormalities:
● AML with t(8;21)(q22;q22); RUNX1-RUNX1T1
● AML with inv(16)(p13.1;q22) or t(16;16)(p13.1;q22); CBF&beta-MYH11
● Acute promyelocytic leukemia with t(15;17)(q22;q12); PML/RAR&alpha and variants
● AML with t(9;11)(p22;q23); MLLT3-MLL
● AML with t(6;9)(p23;q34); DEK-NUP214
● AML with inv(3)(q21q26.2) or t(3;3)(q21;q26.2); RPN1-EVI1
● AML (megakaryoblastic) with t(1;22)(p13;q13); RBM15-MKL1
● AML with mutated NPM1*
● AML with mutated CEBPA*

* provisional

Acute myeloid leukemia with myelodysplasia related changes

Therapy related acute myeloid leukemia
● Alkylating agent related
● Topoisomerase II inhibitor related (some maybe lymphoid)

Acute myeloid leukemia not otherwise categorized:
● AML minimally differentiated (M0)
● AML without maturation (M1)
● AML with maturation (M2)
● Acute myelomonocytic leukemia (M4)
● Acute monoblastic and monocytic leukemia (M5a, M5b)
● Acute erythroid leukemia (M6)
● Acute megakaryoblastic leukemia (M7)
● Acute basophilic leukemia
● Acute panmyelosis with myelofibrosis

Myeloid Sarcoma

Myeloid proliferations related to Down syndrome:
● Transient abnormal myelopoeisis
● Myeloid leukemia associated with Down syndrome

Blastic plasmacytoid dentritic cell neoplasm:

Acute leukemia of ambiguous lineage:
● Acute undifferentiated leukemia
● Mixed phenotype acute leukemia with t(9;22)(q34;q11.2); BCR-ABL1
● 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 acute leukemia of ambiguous lineage

References: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissue (IARC, 2008), Discovery Medicine 2010, eMedicine

End of Leukemia - Acute > AML > Classification


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