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The applicability of the WHO classification in paediatric AML. A NOPHO-AML study

Sandahl, Julie D.; Kjeldsen, Eigil; Abrahamsson, Jonas; Ha, Shau-Yin; Heldrup, Jesper LU ; Jahnukainen, Kirsi; Jonsson, Olafur G.; Lausen, Birgitte; Palle, Josefine and Zeller, Bernward, et al. (2015) In British Journal of Haematology 169(6). p.859-867
Abstract
The World Health Organization (WHO) classification of myeloid leukaemia was revised in 2008. It incorporates newly recognized entities and emphasizes the pivotal role of cytogenetic abnormalities. The aim of this study was to evaluate the usability of the WHO classification when applied to a large population-based paediatric acute myeloid leukaemia (AML) cohort. We included children diagnosed with de novo AML, 0-18years of age from the Nordic countries and Hong Kong from 1993 to 2012. Data were retrieved from the Nordic Society for Paediatric Haematology and Oncology AML database and patients classified according to the WHO 2008 classification. A successful karyotype was available in 97% of the cases. AML with recurrent genetic... (More)
The World Health Organization (WHO) classification of myeloid leukaemia was revised in 2008. It incorporates newly recognized entities and emphasizes the pivotal role of cytogenetic abnormalities. The aim of this study was to evaluate the usability of the WHO classification when applied to a large population-based paediatric acute myeloid leukaemia (AML) cohort. We included children diagnosed with de novo AML, 0-18years of age from the Nordic countries and Hong Kong from 1993 to 2012. Data were retrieved from the Nordic Society for Paediatric Haematology and Oncology AML database and patients classified according to the WHO 2008 classification. A successful karyotype was available in 97% of the cases. AML with recurrent genetic abnormalities were present in 262 (41%) and 94 (15%) were classified as AML with myelodysplasia-related changes (AML-MDS). WHO classifies patients with monosomy 7 and del(7q) into one group. We found that -7 (n=14) had significantly poorer outcome than del(7q) (n=11); 5-year event-free survival 26% vs. 67%, (P=002), and 5-year overall survival 51% vs. 90%, (P=004). The largest group was the highly heterogeneous AML not otherwise specified (NOS) (n=280) (44%). In conclusion, the WHO classification allocated 15% to AML-MDS, 44% to NOS and grouped together entities with clearly different outcome, therefore limiting the applicability of the current WHO classification in children with AML. (Less)
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published
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keywords
paediatrics, acute myeloid leukaemia, World Health Organization, classification, leukaemia
in
British Journal of Haematology
volume
169
issue
6
pages
859 - 867
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • wos:000355657300014
  • scopus:84930268677
ISSN
0007-1048
DOI
10.1111/bjh.13366
language
English
LU publication?
yes
id
27afc5c7-8c14-4ac1-ae09-d42f11f50c1b (old id 7612517)
date added to LUP
2015-08-03 10:11:31
date last changed
2017-10-22 03:08:07
@article{27afc5c7-8c14-4ac1-ae09-d42f11f50c1b,
  abstract     = {The World Health Organization (WHO) classification of myeloid leukaemia was revised in 2008. It incorporates newly recognized entities and emphasizes the pivotal role of cytogenetic abnormalities. The aim of this study was to evaluate the usability of the WHO classification when applied to a large population-based paediatric acute myeloid leukaemia (AML) cohort. We included children diagnosed with de novo AML, 0-18years of age from the Nordic countries and Hong Kong from 1993 to 2012. Data were retrieved from the Nordic Society for Paediatric Haematology and Oncology AML database and patients classified according to the WHO 2008 classification. A successful karyotype was available in 97% of the cases. AML with recurrent genetic abnormalities were present in 262 (41%) and 94 (15%) were classified as AML with myelodysplasia-related changes (AML-MDS). WHO classifies patients with monosomy 7 and del(7q) into one group. We found that -7 (n=14) had significantly poorer outcome than del(7q) (n=11); 5-year event-free survival 26% vs. 67%, (P=002), and 5-year overall survival 51% vs. 90%, (P=004). The largest group was the highly heterogeneous AML not otherwise specified (NOS) (n=280) (44%). In conclusion, the WHO classification allocated 15% to AML-MDS, 44% to NOS and grouped together entities with clearly different outcome, therefore limiting the applicability of the current WHO classification in children with AML.},
  author       = {Sandahl, Julie D. and Kjeldsen, Eigil and Abrahamsson, Jonas and Ha, Shau-Yin and Heldrup, Jesper and Jahnukainen, Kirsi and Jonsson, Olafur G. and Lausen, Birgitte and Palle, Josefine and Zeller, Bernward and Forestier, Erik and Hasle, Henrik},
  issn         = {0007-1048},
  keyword      = {paediatrics,acute myeloid leukaemia,World Health Organization,classification,leukaemia},
  language     = {eng},
  number       = {6},
  pages        = {859--867},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {British Journal of Haematology},
  title        = {The applicability of the WHO classification in paediatric AML. A NOPHO-AML study},
  url          = {http://dx.doi.org/10.1111/bjh.13366},
  volume       = {169},
  year         = {2015},
}