ESCCABase project: A repository in progress.

Leukemia Lineage-Specific Chimerism Analysis and Molecular Monitoring Improve Outcome of Donor Lymphocyte Infusions

MDR-1 and GST Polymorphisms Are Involved in Myelodysplasia Progression,

The Outcomes Of Allogeneic Stem Cell Transplantation In Patients With Mixed Phenotype Acute Leukemia (MPAL) Are Comparable To Those In Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL): Results Of a Matched-Pair Analysis

Objective: Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) are clinically and biologically diverse phenotypic diseases amongst hematological malignancies. The current study objectives were to diagnose and classify cases of AL as per revised 4th edition of WHO 2016 classification of AL’s and study their clinicopathological profiles.Material and Method: This cross-sectional, observational study included 68 patients, diagnosed with AL were recruited. Diagnosis was based on peripheral blood smear examination, bone marrow aspiration, flowcytometry, and cytogenetic and molecular studies.Results: Sixty-eight cases of AL were diagnosed in a period of 2 years, where 25 cases were of ALL and 43 cases were of AML. In the subclassification of AML as per WHO 2016, 20 cases were of AML, RGA, 21 cases were of AML, NOS, and 2 cases were of AML, MRC. In AML, RGA, APL with PML-RARA positive cases were 10 out of 20 cases, AML with (8;21) RUNX1-RUNX1T1 were 7/20 cases; there were two cases of AML with mutated NPM1 gene and one case of AML with biallelic mutation of CEBPA. In AML, NOS subcategory AML with maturation was more common with 9/21cases. In subcategory of ALL, B-ALL was more common than T-ALL. B-ALL, NOS was more common than B-ALL, RGA and we had 1 case of NK cell Leukemia.Conclusion: The application of revised 4th edition WHO 2016 classification confers uniformity in reporting acute leukemia cases that aids in the treatment by using targeted therapies and helps in the prediction of prognosis. The WHO classification for acute leukemias is very objective, therapy oriented and the need of the hour.

SAT0547 Sequential Diagnosis of Sarcoidosis and Malignancy: A close But Complex Association with Four Differential Clinical Scenarios

A Novel Automated Image Analysis System Using Deep Convolutional Neural Networks to Diagnose MDS

A Multicenter Prospective Clinical Study of Venetoclax Combined with Azactidine in the Treatment of Newly Diagnosed Acute Leukaemias of Ambiguous Lineage: Interim Analysis of a Phase 2 Trial

Clinical and Genomic Characterization of Secondary Acute Myeloid Leukemia with Mixed Phenotype

In 2022, two new classifications of myeloid neoplasms and acute leukemias were published: the 5th edition WHO Classification (WHO-HAEM5) and the International Consensus Classification (ICC). As with prior classifications, the WHO-HAEM5 and ICC made updates to the prior classification (revised 4th edition WHO Classification, WHO-HAEM4R) based on a consensus of groups of experts, who examined new evidence. Both WHO-HAEM5 and ICC introduced several new disease entities that are based predominantly on genetic features, superseding prior morphologic definitions. While it is encouraging that two groups independently came to similar conclusions in updating the classification of myeloid neoplasms and acute leukemias, there are several divergences in how WHO-HAEM5 and ICC define specific entities as well as differences in nomenclature of certain diseases. In this review, we highlight the similarities and differences between the WHO-HAEM5 and ICC handling of myeloid neoplasms and acute leukemias and present a practical approach to diagnosing and classifying these diseases in this current era of two divergent classification guidelines.

The International Consensus Classification (ICC) of myeloid neoplasms and acute leukemia has updated the classification of myelodysplastic syndromes (MDSs) and placed MDS in a broader group of clonal cytopenias that includes clonal cytopenia of undetermined significance (CCUS) and related entities. Although subject to some interobserver variability and lack of specificity, morphologic dysplasia remains the main feature that distinguishes MDS from other clonal cytopenias and defines MDS as a hematologic malignancy. The ICC has introduced some changes in the definition of MDS whereby some cases categorized as MDS based on cytogenetic abnormalities are now classified as CCUS, while SF3B1 and multi-hit TP53 mutations are now considered to be MDS-defining in a cytopenic patient. The ICC has also recognized several cytogenetic and molecular abnormalities that reclassify some cases of MDS with excess blasts as acute myeloid leukemia (AML) and has introduced a new MDS/AML entity that encompasses cases with 10-19% blasts that lie on the continuum between MDS and AML. Two new genetically defined categories of MDS have been introduced: MDS with mutated SF3B1 and MDS with mutated TP53, the latter requiring bi-allelic aberrations in the TP53 gene. The entity MDS, unclassifiable has been eliminated. These changes have resulted in an overall simplification of the MDS classification scheme from 8 separate entities (including 1 that was genetically defined) in the revised 4th edition WHO classification to 7 separate entities (including 3 that are genetically defined) in the ICC.

We report an unusual case of myeloperoxidase (MPO)-positive acute megakaryoblastic leukemia (AMKL). The patient was a 63-yr-old woman referred to our hospital with anemia and dyspnea. General physical examination revealed no lymphadenopathy or hepatosplenomegaly. An initial complete blood count indicated white blood cell counts of 26.78 10 9 /L, including 47% blasts, hemoglobin of 7.2 g/dL, and platelets of 519 10 9 /L. A peripheral blood smear showed blasts with prominent nucleoli and blue cytoplasm. Some giant platelets were also observed. A bone marrow (BM) biopsy showed hypercellularity with no fibrosis, packed with blasts, and revealed an increase in megakaryocyte number. BM aspirates showed that blasts accounted for 70% of all nucleated elements. Most blasts had medium-to-large, finely chromatinated nuclei with distinct nucleoli. Some showed multiple clear cytoplasmic projections (Fig. No dysplastic features of hematologic precursors were observed. Cytochemical stain showed some blasts were MPO-positive (Fig.

We reviewed and categorized 638 of 809 patients who were registered in the Japan Adult Leukemia Study Group acute myeloid leukemia (AML)-97 protocol using morphological means. Patients with the M3 subtype were excluded from the study group. According to the WHO classification, 171 patients (26.8%) had AML with recurrent genetic abnormalities, 133 (20.8%) had AML with multilineage dysplasia (MLD), 331 (51.9%) had AML not otherwise categorized, and 3 (0.5%) had acute leukemia of ambiguous lineage. The platelet count was higher and the rate of myeloperoxidase (MPO)-positive blasts was lower in AML with MLD than in the other WHO categories. The outcome was significantly better in patients with high (≥50%) than with low (<50%) ratios of MPO-positive blasts (P < 0.01). The 5-year survival rates for patients with favorable, intermediate, and adverse karyotypes were 63.4, 39.1, and 0.0%, respectively, and 35.5% for those with 11q23 abnormalities (P < 0.0001). Overall survival (OS) did not significantly differ between nine patients with t(9;11) and 23 with other 11q23 abnormalities (P = 0.22). Our results confirmed that the cytogenetic profile, MLD phenotype, and MPO-positivity of blasts are associated with survival in patients with AML, and showed that each category had the characteristics of the WHO classification such as incidence, clinical features, and OS.

Non-Hodgkin’s lymphomas comprise precursor lymphoid neoplasms, mature B-cell neoplasms, and mature T-cell neoplasms. The aetiology of most cases is unknown, but increased risk is associated with immune deficiencies, agricultural chemicals, autoimmune disorders, treated Hodgkin’s disease, and some infectious agents. Incidence varies from 10 to 22 cases per 100 000 per year in different populations. Patients with non-Hodgkin’s lymphoma most commonly present with lymphadenopathy, but other presentations include systemic symptoms or those attributable to mediastinal or retroperitoneal masses or involvement. Diagnosis is typically based on expert evaluation of an adequate lymph node biopsy. Staging depends largely on determining the anatomical extent of disease, with FDG positron emission tomography/CT scanning generally the preferable imaging modality. For most patients, the goal of therapy is to achieve a complete remission. Patients with definitely curable lymphomas, such as diffuse large B-cell lymphoma and Burkitt’s lymphoma, are almost always treated promptly with intensive regimens, for example, chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine (Oncovin), and prednisone) plus the anti-CD20 monoclonal antibody rituximab. By contrast, follicular lymphoma is often not curable and the best treatment is not clear, with many physicians favouring no initial therapy in an asymptomatic patient. Patients who are not cured with initial therapy are candidates for what has been termed ‘salvage therapy’. For most patients, the only curative approach in this setting is haematopoietic stem cell transplantation, the toxicity of which means that it is only sensibly offered to carefully selected patients. Various new agents, such as small molecule kinase and BCL-2 inhibitors, and immune checkpoint inhibitors, offer hope for the future.

The aetiology of most haematological malignancies is largely unknown. Studies of migrant populations can provide insights into the relative importance of genetic and environmental risk factors for these diseases. This study compares incidence rates in British Indians, Pakistanis, Bangladeshis, Black Africans, Black Caribbeans, Chinese and Whites in England from 2001 to 2007. We analysed 134,302 haematological cancer registrations with ethnicity obtained by linkage to the Hospital Episodes Statistics database. Mid-year population estimates from 2001 to 2007 were used. Incidence rate ratios adjusted for age, sex and income were calculated, comparing the six ethnic groups to Whites and to each other. Whites had the highest rates for most subtypes. However, Blacks experienced more than double the incidence of plasma cell and mature T-cell neoplasms compared to other ethnic groups. There were also significant differences in incidence between Indians, Pakistanis and Bangladeshis for Hodgkin lymphoma and mature B-cell neoplasms and between Black African and Black Caribbeans for mature B-cell and other lymphoid neoplasms (all P < 0.001). Our results show that the risk of haematological cancers varies greatly by ethnic group, including within those groups that have traditionally been grouped together (South Asians and Blacks) with many of these differences not explicable by known risk factors.

Outcomes of patients with dual primary T-cell and B-cell lymphoid malignancies