Standardising acute myeloid leukaemia classification systems: a perspective from a panel of international experts

Rory M Shallis; Naval Daver; Jessica K Altman; Rami S Komrokji; Daniel A Pollyea; Talha Badar; Jan P Bewersdorf; Vijaya R Bhatt; Stéphane de Botton; Adolfo de la Fuente Burguera; Hetty E Carraway; Pinkal Desai; Richard Dillon; Nicolas Duployez; Firas El Chaer; Amir T Fathi; Sylvie D Freeman; Ivana Gojo; Michael R Grunwald; Brian A Jonas; Marina Konopleva; Tara L Lin; Gabriel N Mannis; John Mascarenhas; Laura C Michaelis; Alice S Mims; Pau Montesinos; Olga Pozdnyakova; Keith W Pratz; Andre C Schuh; Mikkael A Sekeres; Catherine C Smith; Maximilian Stahl; Marion Subklewe; Geoffrey L Uy; Maria Teresa Voso; Roland B Walter; Eunice S Wang; Joshua F Zeidner; Andrius Žučenka; Amer M Zeidan

doi:10.1016/S2352-3026(23)00159-X

Standardising acute myeloid leukaemia classification systems: a perspective from a panel of international experts

Rory M Shallis, Naval Daver, Jessica K Altman, Rami S Komrokji, Daniel A Pollyea, Talha Badar, Jan P Bewersdorf, Vijaya R Bhatt, Stéphane de Botton, Adolfo de la Fuente Burguera, Hetty E Carraway, Pinkal Desai, Richard Dillon, Nicolas Duployez, Firas El Chaer, Amir T Fathi, Sylvie D Freeman, Ivana Gojo, Michael R Grunwald, Brian A JonasMarina Konopleva, Tara L Lin, Gabriel N Mannis, John Mascarenhas, Laura C Michaelis, Alice S Mims, Pau Montesinos, Olga Pozdnyakova, Keith W Pratz, Andre C Schuh, Mikkael A Sekeres, Catherine C Smith, Maximilian Stahl, Marion Subklewe, Geoffrey L Uy, Maria Teresa Voso, Roland B Walter, Eunice S Wang, Joshua F Zeidner, Andrius Žučenka, Amer M Zeidan^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

Abstract

The existence of two acute myeloid leukaemia classification systems-one put forth by WHO and one by the International Consensus Classification in 2022-is concerning. Although both systems appropriately move towards genomic disease definitions and reduced emphasis on blast enumeration, there are consequential disagreements between the two systems on what constitutes a diagnosis of acute myeloid leukaemia. This fundamental problem threatens the ability of heath-care providers to diagnose acute myeloid leukaemia, communicate with patients and other health-care providers, and deliver appropriate and consistent management strategies for patients with the condition. Clinical trial eligibility, standardised response assessments, and eventual drug development and regulatory pathways might also be negatively affected by the discrepancies. In this Viewpoint, we review the merits and limitations of both classification systems and illustrate how the coexistence, as well as application of both systems is an undue challenge to patients, clinicians, hematopathologists, sponsors of research, and regulators. Lastly, we emphasise the urgency and propose a roadmap, by which the two divergent classification systems can be harmonised.

Original language	English
Journal	The Lancet Haematology
DOIs	https://doi.org/10.1016/S2352-3026(23)00159-X
Publication status	E-pub ahead of print - 9 Aug 2023

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Shallis, R. M., Daver, N., Altman, J. K., Komrokji, R. S., Pollyea, D. A., Badar, T., Bewersdorf, J. P., Bhatt, V. R., de Botton, S., de la Fuente Burguera, A., Carraway, H. E., Desai, P., Dillon, R., Duployez, N., El Chaer, F., Fathi, A. T., Freeman, S. D., Gojo, I., Grunwald, M. R., ... Zeidan, A. M. (2023). Standardising acute myeloid leukaemia classification systems: a perspective from a panel of international experts. The Lancet Haematology. Advance online publication. https://doi.org/10.1016/S2352-3026(23)00159-X

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title = "Standardising acute myeloid leukaemia classification systems: a perspective from a panel of international experts",

abstract = "The existence of two acute myeloid leukaemia classification systems-one put forth by WHO and one by the International Consensus Classification in 2022-is concerning. Although both systems appropriately move towards genomic disease definitions and reduced emphasis on blast enumeration, there are consequential disagreements between the two systems on what constitutes a diagnosis of acute myeloid leukaemia. This fundamental problem threatens the ability of heath-care providers to diagnose acute myeloid leukaemia, communicate with patients and other health-care providers, and deliver appropriate and consistent management strategies for patients with the condition. Clinical trial eligibility, standardised response assessments, and eventual drug development and regulatory pathways might also be negatively affected by the discrepancies. In this Viewpoint, we review the merits and limitations of both classification systems and illustrate how the coexistence, as well as application of both systems is an undue challenge to patients, clinicians, hematopathologists, sponsors of research, and regulators. Lastly, we emphasise the urgency and propose a roadmap, by which the two divergent classification systems can be harmonised.",

author = "Shallis, {Rory M} and Naval Daver and Altman, {Jessica K} and Komrokji, {Rami S} and Pollyea, {Daniel A} and Talha Badar and Bewersdorf, {Jan P} and Bhatt, {Vijaya R} and {de Botton}, St{\'e}phane and {de la Fuente Burguera}, Adolfo and Carraway, {Hetty E} and Pinkal Desai and Richard Dillon and Nicolas Duployez and {El Chaer}, Firas and Fathi, {Amir T} and Freeman, {Sylvie D} and Ivana Gojo and Grunwald, {Michael R} and Jonas, {Brian A} and Marina Konopleva and Lin, {Tara L} and Mannis, {Gabriel N} and John Mascarenhas and Michaelis, {Laura C} and Mims, {Alice S} and Pau Montesinos and Olga Pozdnyakova and Pratz, {Keith W} and Schuh, {Andre C} and Sekeres, {Mikkael A} and Smith, {Catherine C} and Maximilian Stahl and Marion Subklewe and Uy, {Geoffrey L} and Voso, {Maria Teresa} and Walter, {Roland B} and Wang, {Eunice S} and Zeidner, {Joshua F} and Andrius {\v Z}u{\v c}enka and Zeidan, {Amer M}",

year = "2023",

month = aug,

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doi = "10.1016/S2352-3026(23)00159-X",

language = "English",

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Shallis, RM, Daver, N, Altman, JK, Komrokji, RS, Pollyea, DA, Badar, T, Bewersdorf, JP, Bhatt, VR, de Botton, S, de la Fuente Burguera, A, Carraway, HE, Desai, P, Dillon, R, Duployez, N, El Chaer, F, Fathi, AT, Freeman, SD, Gojo, I, Grunwald, MR, Jonas, BA, Konopleva, M, Lin, TL, Mannis, GN, Mascarenhas, J, Michaelis, LC, Mims, AS, Montesinos, P, Pozdnyakova, O, Pratz, KW, Schuh, AC, Sekeres, MA, Smith, CC, Stahl, M, Subklewe, M, Uy, GL, Voso, MT, Walter, RB, Wang, ES, Zeidner, JF, Žučenka, A & Zeidan, AM 2023, 'Standardising acute myeloid leukaemia classification systems: a perspective from a panel of international experts', The Lancet Haematology. https://doi.org/10.1016/S2352-3026(23)00159-X

TY - JOUR

T1 - Standardising acute myeloid leukaemia classification systems

T2 - a perspective from a panel of international experts

AU - Shallis, Rory M

AU - Daver, Naval

AU - Altman, Jessica K

AU - Komrokji, Rami S

AU - Pollyea, Daniel A

AU - Badar, Talha

AU - Bewersdorf, Jan P

AU - Bhatt, Vijaya R

AU - de Botton, Stéphane

AU - de la Fuente Burguera, Adolfo

AU - Carraway, Hetty E

AU - Desai, Pinkal

AU - Dillon, Richard

AU - Duployez, Nicolas

AU - El Chaer, Firas

AU - Fathi, Amir T

AU - Freeman, Sylvie D

AU - Gojo, Ivana

AU - Grunwald, Michael R

AU - Jonas, Brian A

AU - Konopleva, Marina

AU - Lin, Tara L

AU - Mannis, Gabriel N

AU - Mascarenhas, John

AU - Michaelis, Laura C

AU - Mims, Alice S

AU - Montesinos, Pau

AU - Pozdnyakova, Olga

AU - Pratz, Keith W

AU - Schuh, Andre C

AU - Sekeres, Mikkael A

AU - Smith, Catherine C

AU - Stahl, Maximilian

AU - Subklewe, Marion

AU - Uy, Geoffrey L

AU - Voso, Maria Teresa

AU - Walter, Roland B

AU - Wang, Eunice S

AU - Zeidner, Joshua F

AU - Žučenka, Andrius

AU - Zeidan, Amer M

PY - 2023/8/9

Y1 - 2023/8/9

N2 - The existence of two acute myeloid leukaemia classification systems-one put forth by WHO and one by the International Consensus Classification in 2022-is concerning. Although both systems appropriately move towards genomic disease definitions and reduced emphasis on blast enumeration, there are consequential disagreements between the two systems on what constitutes a diagnosis of acute myeloid leukaemia. This fundamental problem threatens the ability of heath-care providers to diagnose acute myeloid leukaemia, communicate with patients and other health-care providers, and deliver appropriate and consistent management strategies for patients with the condition. Clinical trial eligibility, standardised response assessments, and eventual drug development and regulatory pathways might also be negatively affected by the discrepancies. In this Viewpoint, we review the merits and limitations of both classification systems and illustrate how the coexistence, as well as application of both systems is an undue challenge to patients, clinicians, hematopathologists, sponsors of research, and regulators. Lastly, we emphasise the urgency and propose a roadmap, by which the two divergent classification systems can be harmonised.

AB - The existence of two acute myeloid leukaemia classification systems-one put forth by WHO and one by the International Consensus Classification in 2022-is concerning. Although both systems appropriately move towards genomic disease definitions and reduced emphasis on blast enumeration, there are consequential disagreements between the two systems on what constitutes a diagnosis of acute myeloid leukaemia. This fundamental problem threatens the ability of heath-care providers to diagnose acute myeloid leukaemia, communicate with patients and other health-care providers, and deliver appropriate and consistent management strategies for patients with the condition. Clinical trial eligibility, standardised response assessments, and eventual drug development and regulatory pathways might also be negatively affected by the discrepancies. In this Viewpoint, we review the merits and limitations of both classification systems and illustrate how the coexistence, as well as application of both systems is an undue challenge to patients, clinicians, hematopathologists, sponsors of research, and regulators. Lastly, we emphasise the urgency and propose a roadmap, by which the two divergent classification systems can be harmonised.

U2 - 10.1016/S2352-3026(23)00159-X

DO - 10.1016/S2352-3026(23)00159-X

M3 - Review article

C2 - 37572683

SN - 2352-3026

JO - The Lancet Haematology

JF - The Lancet Haematology

ER -

Standardising acute myeloid leukaemia classification systems: a perspective from a panel of international experts

Abstract

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