Table 1.
Latest classifications of acute myeloid leukemia
| 2022 International consensus classification (ICC) [12] | 2022 5th-WHO classification [11] |
|---|---|
|
-Acute promyelocytic leukemia (APL) with t(15;17)(q24.1;q21.2)/PML::RARA (blasts ≥10%) -APL with other RARA rearrangements* (blasts ≥10%) |
Acute promyelocytic leukaemia with PML::RARA fusion (no blasts cutoff) |
| AML with t(8;21)(q22;q22.1)/RUNX1::RUNX1T1 (blasts ≥10%) | Acute myeloid leukaemia with RUNX1::RUNX1T1 fusion (no blasts cutoff) |
|
AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22)/CBFB::MYH11 (blasts ≥10%) |
Acute myeloid leukaemia with CBFB::MYH11 fusion (no blasts cutoff) |
| AML with t(6;9)(p22.3;q34.1)/DEK::NUP214 (blasts ≥10%) | Acute myeloid leukaemia with DEK::NUP214 fusion (no blast cut-off) |
|
-AML with t(9;11)(p21.3;q23.3)/MLLT3::KMT2A (blasts ≥10%) -AML with other KMT2A rearrangements** (blasts ≥10%) |
Acute myeloid leukaemia with KMT2A rearrangements (no blasts cutoff) |
|
-AML with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2)/GATA2::MECOM(EVI1) (blasts ≥10%) -AML with other MECOM rearrangements*** (blasts ≥10%) |
Acute myeloid leukaemia with MECOM rearrangements (no blasts cut-off) |
| -AML with other rare recurring translocations (including NUP98 rearrangement and RBM15::MRTF1 fusion) (blasts ≥10%) | Acute myeloid leukaemia with other defined genetic alterations (no blasts cut-off) |
| AML with t(9;22)(q34.1;q11.2)/BCR::ABL1 (blasts ≥20%) | Acute myeloid leukaemia with BCR::ABL1 fusion (blasts ≥20%) |
| AML with mutated NPM1 (blasts ≥10%) | Acute myeloid leukaemia with NPM1 mutation (no blasts cut-off) |
| AML with in-frame bZIP CEBPA mutations (blasts ≥10%) | Acute myeloid leukaemia with CEBPA mutation (blasts ≥20%) |
| -AML with mutated TP53 (blasts ≥20%) | Acute myeloid leukaemia, myelodysplasia-related (blasts ≥20%) |
| -AML with myelodysplasia-related gene mutations (blasts ≥20%) Defined by mutations in ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, or ZRSR2 |
Acute myeloid leukaemia, myelodysplasia-related (blasts ≥20%) Defined by mutations in ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, or ZRSR2 |
|
AML with myelodysplasia-related cytogenetic abnormalities (blasts ≥20%). Defined by detecting a complex karyotype ( ≥3 unrelated clonal chromosomal abnormalities in the absence of other class-defining recurring genetic abnormalities), del(5q)/t(5q)/add(5q), -7/del(7q), +8, del(12p)/t(12p)/add(12p), i(17q), -17/add(17p) or del(17p), del(20q), and/or idic(X)(q13) clonal abnormalities |
Acute myeloid leukaemia, myelodysplasia-related (blasts ≥20%). Defined by a complex karyotype (≥3 abnormalities); 5q deletion or loss of 5q due to unbalanced translocation; monosomy 7, 7q deletion, or loss of 7q due to unbalanced translocation; 11q deletion; 12p deletion or loss of 12p due to unbalanced translocation; monosomy 13 or 13q deletion; 17p deletion or loss of 17p due to unbalanced translocation; isochromosome 17q; idic(X)(q13) |
| AML not otherwise specified (NOS) (blasts ≥20%) | AML, defined by differentiation (blasts ≥20%)# |
| Myeloid sarcoma | Myeloid sarcoma |
*Includes AMLs with t(1;17)(q42.3;q21.2)/IRF2BP2::RARA; t(5;17)(q35.1;q21.2)/NPM1::RARA; t(11;17)(q23.2;q21.2)/ZBTB16::RARA; cryptic inv(17q) or del(17)(q21.2q21.2)/STAT5B::RARA, STAT3::RARA; other genes rarely rearranged with RARA:TBL1XR1 (3q26.3), FIP1L1 (4q12), BCOR (Xp11.4)
**Includes AMLs with t(4;11)(q21.3;q23.3)/AFF1::KMT2A#; t(6;11)(q27;q23.3)/AFDN::KMT2A; t(10;11)(p12.3;q23.3)/MLLT10::KMT2A; t(10;11)(q21.3;q23.3)/TET1::KMT2A; t(11;19)(q23.3;p13.1)/KMT2A::ELL; t(11;19)(q23.3;p13.3)/KMT2A::MLLT1# (# Occurs predominantly in infants and children)
***Includes AMLs with t(2;3)(p11~23;q26.2)/MECOM::?; t(3;8)(q26.2;q24.2)/MYC, MECOM; t(3;12)(q26.2;p13.2)/ETV6::MECOM; t(3;21)(q26.2;q22.1)/MECOM::RUNX1
#Includes AML with minimal differentiation, AML without maturation, AML with maturation, acute basophilic leukaemia, acute myelomonocytic leukaemia, acute monocytic leukaemia, acute erythroid leukaemia, and acute megakaryoblastic leukaemia