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Database-guided Flow-cytometry for Evaluation of Bone Marrow Myeloid Cell Maturation

Database-guided Flow-cytometry for Evaluation of Bone Marrow Myeloid Cell Maturation

Published on: November 3, 2018

Fifth edition WHO classification: myeloid neoplasms.

Xueyan Chen^1,2, Nikhil Patkar³, Prashant Tembhare³

¹Section of Pathology, Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.

Journal of Clinical Pathology

|February 13, 2025

Summary

This summary is machine-generated.

The WHO classification of haematolymphoid tumours (WHO-HEM5) now integrates genetic insights for diagnosing myeloid neoplasms, improving precision. Strategies are explored to implement these advancements in resource-limited settings for better global outcomes.

Keywords:

Bone Marrow Neoplasms DIAGNOSIS FLOW CYTOMETRY IMMUNOHISTOCHEMISTRY Leukemia

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Area of Science:

Hematopathology
Oncology
Genetics

Background:

The WHO classification of haematolymphoid tumours (WHO-HEM5) represents a significant update from WHO-HEM4R.
It emphasizes molecular and genetic insights for diagnosing myeloid neoplasms.

Purpose of the Study:

To highlight key updates in WHO-HEM5, focusing on genetic criteria for myeloid neoplasm classification.
To discuss the challenges and strategies for implementing WHO-HEM5 in low- and middle-income countries (LMICs).

Main Methods:

Review of the fifth edition of the WHO classification of haematolymphoid tumours (WHO-HEM5).
Analysis of the integration of genetic criteria and updated diagnostic thresholds.
Exploration of diagnostic strategies for resource-constrained environments.

Main Results:

WHO-HEM5 defines many myeloid neoplasms by specific genetic abnormalities, enhancing diagnostic precision.
The 20% blast threshold for acute myeloid leukaemia (AML) with specific genetic alterations has been removed.
New entities like clonal hematopoiesis and MDS with biallelic TP53 inactivation are recognized.

Conclusions:

WHO-HEM5 refines the classification and risk stratification of myeloid neoplasms, supporting personalized medicine.
Integrating molecular diagnostics with traditional methods is crucial for advancing global hematopathology practices.
Optimizing diagnosis in LMICs requires adapting advanced tools and leveraging fundamental techniques like morphology and immunophenotyping.