Ng, Ashley P

Adams, Rebecca

Tiong, Ing Soo

Seymour, Louise

Talaulikar, Dipti

Palfreyman, Emma

Enjeti, Anoop

Tate, Courtney

2024-05-31

The classification of myeloid neoplasms continues to evolve along with advances in molecular diagnosis, risk stratification and treatment of disease. An approach for disease classification has been grounded in international consensus that has facilitated understanding, identification and management of molecularly heterogeneous entities, as well as enabled consistent patient stratification into clinical trials and clinical registries over time. The new World Health Organization (WHO) and International Consensus Classification (ICC) Clinical Advisory Committee releasing separate classification systems for myeloid neoplasms in 2022 precipitated some concern amongst haematopathology colleagues both locally and internationally. While both classifications emphasise molecular disease classification over the historical use of morphology, flow cytometry and cytogenetic based diagnostic methods, notable differences exist in how morphological, molecular and cytogenetic criteria are applied for defining myelodysplastic neoplasms (MDS) and acute myeloid leukaemias (AML). Here we review the conceptual advances, diagnostic nuances, and molecular platforms required for the diagnosis of MDS and AML using the new WHO and ICC 2022 classifications. We provide consensus recommendations for reporting bone marrow biopsies. Additionally, we address the logistical challenges encountered implementing these changes into routine laboratory practice in alignment with the National Pathology Accreditation Advisory Council reporting requirements for Australia and New Zealand.

Clinical Haematology Department, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Parkville, Vic, Australia; The Walter and Eliza Hall Institute of Medical Research, Parkville, Vic, Australia; Department of Biology, University of Melbourne, Parkville, Vic, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Vic, Australia; The Royal College of Pathologists of Australasia, Sydney, NSW, Australia. Electronic address: ashley.ng@mh.org.au.

The Royal College of Pathologists of Australasia, Sydney, NSW, Australia; The Haematology Advisory Committee, Royal College of Pathologists of Australasia, Sydney, NSW, Australia; Sullivan Nicolaides Pathology, Brisbane, Qld, Australia; The University of Queensland, Brisbane, Qld, Australia.

The Royal College of Pathologists of Australasia, Sydney, NSW, Australia; Department of Pathology, Peter MacCallum Cancer Centre, Parkville, Vic, Australia; The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia.

The Royal College of Pathologists of Australasia, Sydney, NSW, Australia; The University of Queensland, Brisbane, Qld, Australia; Pathology Queensland, Brisbane, Qld, Australia.

The Royal College of Pathologists of Australasia, Sydney, NSW, Australia; The Haematology Advisory Committee, Royal College of Pathologists of Australasia, Sydney, NSW, Australia; Department of Haematology, Canberra Health Services, Canberra, ACT, Australia; College of Health and Medicine, Australian National University, Canberra, ACT, Australia.

The Royal College of Pathologists of Australasia, Sydney, NSW, Australia; The Haematology Advisory Committee, Royal College of Pathologists of Australasia, Sydney, NSW, Australia; Department of Haematology, Royal Darwin Hospital, Tiwi, NT, Australia.

The Royal College of Pathologists of Australasia, Sydney, NSW, Australia; The Haematology Advisory Committee, Royal College of Pathologists of Australasia, Sydney, NSW, Australia; Department of Haematology, Calvary Mater Newcastle Hospital, Waratah, NSW, Australia; NSW Health Pathology, John Hunter Hospital, New Lambton Heights, NSW, Australia; Precision Medicine Program, Hunter Medical Research Institute and University of Newcastle, Newcastle, NSW, Australia.

The Royal College of Pathologists of Australasia, Sydney, NSW, Australia; The Haematology Advisory Committee, Royal College of Pathologists of Australasia, Sydney, NSW, Australia; The University of Queensland, Brisbane, Qld, Australia; Pathology Queensland, Brisbane, Qld, Australia; Princess Alexandra Hospital, Brisbane, Qld, Australia.

Pathology . 2024 Jun;56(4):459-467. doi: 10.1016/j.pathol.2024.02.002. Epub 2024 Mar 19.

1465-3931

https://pubmed.ncbi.nlm.nih.gov/38580613/?otool=iaurydwlib

https://hdl.handle.net/10137/13281

International Consensus Conference

Myelodysplasia

World Health Organization

acute myeloid leukaemia

Humans

Leukemia, Myeloid, Acute

Myelodysplastic Syndromes

World Health Organization

Bone Marrow

Biopsy

Consensus

Australia

Reporting bone marrow biopsies for myelodysplastic neoplasms and acute myeloid leukaemia incorporating WHO 5th edition and ICC 2022 classification systems: ALLG/RCPA joint committee consensus recommendations.

Journal Article

Publication