Guide to the Diagnosis of Myeloid Neoplasms: A Bone Marrow Pathology Group Approach

Authors

Kathryn Foucar, Department of Pathology, University of New Mexico, Albuquerque, NM, US.
Adam Bagg, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, US.
Carlos E. Bueso-Ramos, Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, US.
Tracy George, Department of Pathology, University of Utah, Salt Lake City, UT, US.
Robert P Hasserjian, Department of Pathology, Massachusetts General Hospital, Boston, MA, US.
Eric D. Hsi, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, US.
Attilio Orazi, Department of Pathology, Texas Tech University, El Paso, TX, US.
Wayne Tam, Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Greenvale, NY, US.
Sa A. Wang, Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, US.
Olga K. Weinberg, Department of Pathology, University of Chicago, Chicago, IL, US.
Daniel A. Arber, Department of Pathology, University of Chicago, Chicago, IL, US.

Document Type

Article

Publication Date

10-3-2023

Abstract

OBJECTIVES: The practicing pathologist is challenged by the ever-increasing diagnostic complexity of myeloid neoplasms. This guide is intended to provide a general roadmap from initial case detection, often triggered by complete blood count results with subsequent blood smear review, to final diagnosis.

METHODS: The integration of hematologic, morphologic, immunophenotypic, and genetic features into routine practice is standard of care. The requirement for molecular genetic testing has increased along with the complexity of test types, the utility of different testing modalities in identifying key gene mutations, and the sensitivity and turnaround time for various assays.

RESULTS: Classification systems for myeloid neoplasms have evolved to achieve the goal of providing a pathology diagnosis that enhances patient care, outcome prediction, and treatment options for individual patients and is formulated, endorsed, and adopted by hematologists/oncologists.

CONCLUSIONS: This guide provides diagnostic strategies for all myeloid neoplasm subtypes. Special considerations are provided for each category of testing and neoplasm category, along with classification information, genetic testing requirements, interpretation information, and case reporting recommendations based on the experience of 11 Bone Marrow Pathology Group members.

Recommended Citation

Foucar K, Bagg A, Bueso-Ramos CE, George T, Hasserjian RP, Hsi ED, Orazi A, Tam W, Wang SA, Weinberg OK, Arber DA. Guide to the Diagnosis of Myeloid Neoplasms: A Bone Marrow Pathology Group Approach. Am J Clin Pathol. 2023 Oct 3;160(4):365-393. doi: 10.1093/ajcp/aqad069. PMID: 37391178.