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WHO 2008 Overview of the classification of the myeloid neoplasms  -Myeloproliferative neoplasms  -Myeloid and lymphoid neoplasms with eosinophilia and.

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Presentation on theme: "WHO 2008 Overview of the classification of the myeloid neoplasms  -Myeloproliferative neoplasms  -Myeloid and lymphoid neoplasms with eosinophilia and."— Presentation transcript:

1 WHO 2008 Overview of the classification of the myeloid neoplasms  -Myeloproliferative neoplasms  -Myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1  -Myelodysplastic/myeloproliferative neoplasms  -Myelodysplastic syndromes  -Acute myeloid leukaemia (AML) and related precursor neoplasms  -Acute leukaemias of ambiguous lineage  -

2 WHO 2001 WHO 2008 AML

3  WHO 2001  > 20% blasten in beenmerg of bloed  Promonocyten worden bij de blasten gerekend  uitzondering AML met t(8;21), inv(16),t(16;16) of t(15;17):  AML onafhankelijk van blasten %  WHO 2008  > 20% blasten in beenmerg of bloed  Promonocyten worden bij de blasten gerekend  uitzondering AML met t(8;21), inv(16),t(16;16) of t(15;17):  AML onafhankelijk van blasten %

4 Samenvatting AML classificaties WHO 2001 en WHO 2008  WHO 2001  -AML with recurrent cytogenetic abnormalities  -AML with multilineage dysplasia  -AML and MDS therapy related  -AML not otherwise categorized  -Acute leukemias of ambiguous lineage  WHO 2008  -AML with recurrent genetic abnormalities  -AML with myelodysplasia related changes  -Therapy related myeloid neoplasms  -AML not otherwise specified (NOS)  -Myeloid sarcoma  -Myeloid proliferations related to Down syndrome  -Blastic plasmacytoids dendritic cell neoplasms

5  WHO 2001  AML with recurrent cytogenetic abnormalities  t(8;21)(q22;q22) AML1/ETO  inv(16)(p13.1q22) of t(16;16)(p13q22);CBFB-MYH11  t(15;17) (q22;q12);PML-RARA  11q23 (MLL) abnormalities  WHO 2008  AML with recurrent genetic abnormalities  t(8;21)(q22;q22) RUNX1-RUNX1T1  inv(16)(p13.1q22) of t(16;16)(p13.1q22);CBFB-MYH11  t(15;17) (q22;q12);PML-RARA  t(9;11)(p22;q23);MLLT3-MLL  t(6;9)(p23;q34);DEK-NUP214  inv(3) of t(3;3);RPMN1-EVI1  t(1;22)(p13;q13) RBM15-MKL1  mutated NPM1  mutated CEBPA

6 WHO 2001 AML with multilineage dysplasia > 50% dysplasie in 2 of 3 cellijnen Eventueel na gedocumenteerde MDS  WHO 2008  AML with myelodysplasia-related changes  Voorafgaande gedocumenteerde MDS of MDS/MPN  of  MDS gerelateerde cytogenetische afwijking  Complex kayotype: >3 unrelated abnormalities  Unbalanced abnormalities zoals bijv. – 7/del(7q) en –5/(del5q)  Balanced abnormalities bijv. t(2;11)  Zie blz. 125 WHO 2008  of  Multilineage dysplasia (> 50% in 2 of 3 cellijnen)  Geen voorafgaande cytotoxische therapie  Geen t(8;21) inv(16) of t(15;17)

7  WHO 2001  AML and MDS, therapy related  WHO 2008  Therapy-related myeloid neoplasms  t-AML  t-MDS  t-MDS/MPN

8  WHO 2001  AML not otherwise categorised  AML, minimally differentiated  AML without maturation  AML with maturation  Acute myelomonocytic leukemia  Acute monoblastic and monocytic leukemia  Acute erythroid leukemia  Acute megakaryoblastic leukemia  Acute basophilic leukemia  Acute panmyelosis with myelofibrosis  Myeloid sarcoma  WHO 2008  Acute myeloid leukemia, not otherwise specified AML, NOS  AML, minimally differentiated  AML without maturation  AML with maturation  Acute myelomonocytic leukemia  Acute monoblastic and monocytic leukemia  Acute erythroid leukemia  Acute megakaryoblastic leukemia  Acute basophilic leukemia  Acute panmyelosis with myelofibrosis

9 Acute eryhtroid leukemia  Indien > 50% erythroblasten in het beenmerg, dan wordt het percentage myeloblasten berekend over de NEC  (= non-erythroid cells= granulocytaire cellen).  Myeloblasten als % berekend van de granulocytaire lijn,  indien > 20: AML, erythroleukemia (erythroid/myeloid)

10  WHO 2008  Myeloid sarcoma

11  WHO 2008  Myeloid proliferations related to Down syndrome  Transient abnormal myelopoiesis  Myeloid leukemia associated with Down syndrome

12  WHO 2008  Blastic plasmacytoid dendritic cell neoplasm  Vroeger:  Blastic NK-cell leukemia  Geassocieerd met MDS

13  WHO 2001  Acute leukemias of ambiguous lineage  Undifferentiated acute leukemiahooguit 1 lijn specifieke marker  Bilineal acute leukemia2 populaties  Biphenotypic acute leukemiaco-expressie myeloid / B / T merkers  EGIL scoring system

14 EGIL criteria BAL > 2punten voor 2 differentiatielijnen puntenB-cellijnT-cellijnMyeloide lijn 2 Cy CD79a Cy IgM Cy CD22 CD3 (cy of Sg) T-celreceptor αβ T-celreceptor γδ MPO 1 CD19 CD10 CD20 CD2 CD5 CD8 CD10 CD13 CD33 CD65 CD TdT CD24 TdT CD7 CD1a CD14 CD15 CD64

15  WHO 2008  Acute leukemias of ambiguous lineage  Acute undifferentiated leukemia  Mixed phenotype acute leukemia with t(9;22)(q34;q11.2);BCR;ABL  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 ambiguous lineage leukemias

16  WHO 2008:  EGIL scoring system wordt niet meer gebruikt

17 MPAL: meer dan 2 lijnen Eisen voor classificatie MPAL B-cellijnT-cellijnMyeloide lijn Sterke expressie CD19 met Sterke expressie cyCD22 of CD10 of cyCD79a Sterke expressie CD3 (cy of Sg) Expressie MPO Of Zwakke expressie CD19 met sterke expressie van tenminste 2 merkers: cyCD22, CD10, of cyCD79a Of Aanwezigheid minstens 2 monocytaire merkers: CD11c, CD14, CD64, lysozym, esterase


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