2022年急性髓性白血病分类在现实环境中的适用性
Enrico Attardi1, Arianna Savi2, Beatrice Borsellino1
1Department of Biomedicine and Prevention, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy.
2022年急性髓性白血病 (AML) 的新分类显著改善了诊断. 现实世界的应用表明,传统的细胞遗传学仍然至关重要,这表明需要一个统一的诊断模型.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 分子遗传学 分子遗传学
背景情况:
- 急性髓性白血病 (AML) 的分子遗传学的进步推动了诊断和预后方案的更新.
- 新的分类包括世界卫生组织 (WHO) 2022年,国际共识分类 (ICC) 和欧洲白血病网络 (ELN) 2022年建议.
研究的目的:
- 在现实临床环境中应用和评估新的AML分类模型.
- 确定世卫组织2022年,ICC和ELN2022计划之间的差异和相似之处.
- 评估这些新分类在常规AML诊断中的实施情况.
主要方法:
- 根据世卫组织2022年,ICC和ELN2022计划,重新分类1001名被诊断为AML的患者.
- 新分类与世卫组织2016年方案之间的患者分布和类型大小的比较.
- 分析传统细胞遗传学在诊断骨髓质疏松症 (MDS) 相关的AML中的作用.
主要成果:
- 观察到显著的诊断变化:22.8%在世卫组织2016年和世卫组织2022年之间,23.7%在世卫组织2016年和ICC之间.
- 患者分布在ICC和WHO2022之间发生了转移 (13.1%的差异),而"未另行说明"和"通过差异化定义"的类别正在缩小.
- 与MDS相关的AML组的扩大,在ICC定义的MDS相关的AML病例中,有55.9%的AML病例显示出相关的型. 2017年ELN到2022年ELN的重组是12.9%的.
结论:
- 2022年的AML分类代表了诊断方案的显著改进.
- 传统的细胞遗传学在诊断二次AML方面仍然发挥着至关重要的作用,在56%的病例中分层.
- 世卫组织和ICC之间的相似之处表明,统一的诊断模型是可取的.
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