The International Consensus Classification of acute myeloid leukemia

Authors

Olga K. Weinberg, Department of Pathology, University of Texas Southwestern Medical Center, BioCenter, 2230 Inwood Rd, Dallas, TX, EB03.220G75235, USA. Olga.weinberg@UTSouthwestern.edu
Anna Porwit, Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
Attilio Orazi, Department of Pathology, Texas Tech University Health Sciences Center, El Paso, El Paso, TX, USA
Robert P Hasserjian, Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
Kathryn Foucar, Department of Pathology, University of New Mexico, Albuquerque, NM, USA
Daniel A Arber, Department of Pathology, University of Chicago, Chicago, IL, USA
Eric J. Duncavage, Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA

Document Type

Article

Publication Date

1-1-2023

Abstract

Acute myeloid leukemias (AMLs) are overlapping hematological neoplasms associated with rapid onset, progressive, and frequently chemo-resistant disease. At diagnosis, classification and risk stratification are critical for treatment decisions. A group with expertise in the clinical, pathologic, and genetic aspects of these disorders developed the International Consensus Classification (ICC) of acute leukemias. One of the major changes includes elimination of AML with myelodysplasia-related changes group, while creating new categories of AML with myelodysplasia-related cytogenetic abnormalities, AML with myelodysplasia-related gene mutations, and AML with mutated TP53. Most of recurrent genetic abnormalities, including mutations in NPM1, that define specific subtypes of AML have a lower requirement of ≥ 10% blasts in the bone marrow or blood, and a new category of MDS/AML is created for other case types with 10-19% blasts. Prior therapy, antecedent myeloid neoplasms or underlying germline genetic disorders predisposing to the development of AML are now recommended as qualifiers to the initial diagnosis of AML. With these changes, classification of AML is updated to include evolving genetic, clinical, and morphologic findings.

Recommended Citation

Weinberg OK, Porwit A, Orazi A, Hasserjian RP, Foucar K, Duncavage EJ, Arber DA. The International Consensus Classification of acute myeloid leukemia. Virchows Arch. 2023 Jan;482(1):27-37. doi: 10.1007/s00428-022-03430-4. Epub 2022 Oct 20. PMID: 36264379.