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世界卫生组织第五版分类和骨髓增生性肿瘤国际共识分类:分子时代的不断发展的指南,具有实际意义。

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.

机构信息

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.

Department of Pathology, University of Utah School of Medicine, ARUP Laboratories, Salt Lake City, Utah.

出版信息

Curr Opin Hematol. 2023 Mar 1;30(2):53-63. doi: 10.1097/MOH.0000000000000748. Epub 2022 Dec 23.

Abstract

PURPOSE OF REVIEW

There 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 FINDINGS

The 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.

SUMMARY

Integration 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.

摘要

目的综述

髓系肿瘤的分子发病机制的认识已经取得了重大进展,这促使第五版世界卫生组织分类(WHO-5)和新的国际共识分类(ICC)对髓系肿瘤的分类进行了更新。本文的目的是概述这两种髓系肿瘤的分类系统。

最近的发现

在 WHO-5 和 ICC 中,许多髓系实体的定义、分类和诊断标准已经得到了完善,对形态学的理解和新的遗传学发现的整合也得到了改善。特别是,分子和细胞遗传学研究已经越来越多地纳入髓系肿瘤的分类、风险分层和治疗选择。总体而言,尽管 WHO-5 和 ICC 之间存在一些修订和差异,但髓系肿瘤的主要类别仍然相同。需要进一步的验证研究来调整和理想地整合这两种分类。

总结

正如 WHO-5 和 ICC 所建议的那样,整合临床信息、实验室参数、形态特征以及细胞遗传学和分子研究对于髓系肿瘤的分类至关重要。

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