AML Classification Flashcards
(18 cards)
WHO 5thEd classification 2022 for AML?
- AML with defining genetic abnormalities
- AML, defined by differentiation
- Myeloid sarcoma
Blast cut off for AML c defining genetic abnormalities? (5th WHO 2022)
No cut off
except >=20% blasts in BM or blood in AML with BCR::ABL1 and AML with CEBPA mutation; also MDS-related
List AML with defining genetic abnormalities (13)
“Penny’s Runs Cool Circle, Dek Red Big Kaman Mecom Noop New MDS other”
- Penny: PML::RARA fusion
- Runs: RUNX1::RUNX1T1
- Cool: CEBPA**
- Circles: CBFB::MYH11
- Dek: DEK::NUP214
- Red: RBM15::MRTFA
- Big: BCR::ABL1 fusion**
- Kaman: KMT2A rearrangement
- Mecom: MECOM
- Noop: NUP98
- New: NPM1 mutation
- MDS: related**
- other defined genetic alteration
** = need >=20%
CEBPA mutation (5th WHO 2022)
Biallelic CEBPA and single mutations located in basic leucine zipper (bZIP)region
AML, myelodysplasia-related (5th WHO 2022) comprised of (2)
- Defining cytogenic abn
- Defining somatic mutations
AML, MDS-related - defining cytogenetic abnormalities (5th WHO 2022)
🧬 Mnemonic: “5, 7, 11, 12, 13, 17, X”
Complex karyotype (>=3 abn)
Chromosome 5 abnormalities: Del(5q), t(5q), or add(5q)
Chromosome 7 abnormalities: Monosomy 7, del(7q), or loss of 7q
Chromosome 11 abnormalities: Del(11q)
Chromosome 12 abnormalities: Del(12p) or loss of 12p
Chromosome 13 abnormalities: Monosomy 13 or del(13q)
Chromosome 17 abnormalities: Del(17p) or loss of 17p, isochromosome 17q
Chromosome X abnormalities: idic(X)(q13)
AML, MDS-related - defining somatic mutations (5th WHO 2022)
🧬”ABE tripleS UZ +-R”
A: ASXL1
B: BCOR
E: EZH2
TripleS: SF3B1, SRSF2, STAG2
U: U2AF1
Z: ZRSR2
+-R: RUNX1 (no runx1 in who)
AML, MDS-related - defining somatic mutations (5th WHO 2022) — by mechanisms
- ABE: epigenetic modifiers
- SS UZ: spliceosome mutations
- STAG2: cohesin complex
- RUNX1: transcription factor
Common epigenetic modifier mutations in AML (2)
DNA methylation & histone modification
List DNA methylation (4)
🧬 Mr. TEDDy
TE: TET2
DD: DNMT2A, IDH
M: MLL
List Histone modification (4)
🧬 “ACE H”
ASXL1
CBP
EZH2
HDAC
What’s difference between 5th who2022 and ICC2022 for AML, myelodysplasia related??
- WHO: got 11q del, mono13, 13q del; no RUNX1
- ICC: got +8; and RUNX1
What’s difference between 5th who2022 and ICC2022 for secondary myeloid neoplasm??
therapy-related myeloid neoplasms
- WHO: MNs secondary to exposure to cytotoxic therapy (MN-pCT)
- ICC: as diagnostic qualifiers; therapy-related AML
MN c germline predisposition
- WHO: MNs secondary to germline predisposition
- ICC: germline predisposition
How to diagnose AML, myelodysplasia-related? (Who 2022)
> =20% blasts with
- specific cytogenetic & molecular abnormalities assoc with MDS or
- known hx of MDS or MDS/MPN
*not include RUNX1 due to lack of sufficient unifying characteristics
FAB classification AML
M0: .AML c minimal differentiation
M1: AML w/o maturation
M2: AML with maturation
M3: APL
M4: Acute myelomonocytic leukemia
M5: Acute monoblastic and monocytic leukemia
M6: Pure erythoid leukemia
M7: Acute megakaryoblastic leukemia
How to diagnose AML, defined by differentiation (5th WHO 2022)
> =20% blasts in BM and/or blood except acute erythroid leukemia
Lack of defining genetic abnormalities according
Not met criteria for MPAL, MN post cytotoxic Tx
No prior hx of MPN
How to diagnose Acute erythroid leukemia (5th WHO 2022)
> =30% proerythoblasts with erythroid >=80% of cellularity
List AML, defined by differentiation (5th WHO 2022) (8)
- AML with minimal differentiation
- AML w/o maturation
- AML with maturation
- Acute basophilic leukemia
- Acute myelomonocytic leukemia
- Acute monocytic leukemia
- Acute erythroid leukemia
- Acute megakaryoblastic leukemia
