Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ann Lab Med. 2019 May;39(3):311-316. doi: 10.3343/alm.2019.39.3.311.
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 was the most common form (16.5%), with the majority associated with monocytic differentiation (63.6%). AML with double 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 and AML with myelodysplasia-related changes comprised the oldest patients, whereas AML with included the youngest patients. The leukocyte count was highest in AML with mutated , and the percentage of peripheral blood blasts was the highest in AML with double 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.
我们回顾了我们的白血病数据库，根据 2016 年 WHO 分类标准，重新分类了 610 例先前诊断为急性髓系白血病（AML）的患者。9 例患者被归类为骨髓增生异常综合征和具有种系易感性的髓系肿瘤。在 2016 年 WHO 分类标准下，具有复发性遗传异常的 AML 占 601 例患者的 57.4%（345/601）。突变的 AML 是最常见的形式（16.5%），大多数与单核细胞分化相关（63.6%）。AML 中存在双 突变占这些病例的 8.3%，且大多数以前被诊断为 AML 伴/不伴成熟（78.0%）。这些新分类的突变是相互排斥的，与其他形式的复发性遗传异常的 AML 没有重叠。突变的 AML 和伴骨髓增生异常相关改变的 AML 患者年龄最大，而 突变的 AML 患者年龄最小。突变的 AML 中的白细胞计数最高，双 突变的 AML 中的外周血原始细胞比例最高。我们的结果表明，在临床实践中实施 2016 年 WHO 分类标准 AML 不会带来重大困难。血液病理学家应根据其临床实验室条件，审查和准备新分类的基因检测。
