Who Classification of AML: Demystifying Your Leukemia Diagnosis

Leukemia is a type of blood cancer that affects the body’s production of white blood cells. Acute myeloid leukemia (AML) is a type of leukemia that develops in the myeloid cells, which are responsible for producing red and white blood cells and platelets. AML is a type of cancer that can be fatal if not treated properly.

What is the WHO Classification of AML?

The World Health Organization (WHO) has developed a classification system for AML to help doctors better diagnose and treat the disease. The WHO classification system is based on the type of cell that is affected by the cancer and the percentage of these cells in the bone marrow or blood.

The WHO classification of AML is divided into different categories, including:

  • AML with recurrent genetic abnormalities
  • AML with myelodysplasia-related changes
  • AML not otherwise specified
  • AML with minimal differentiation
  • AML without maturation
  • Acute myelomonocytic leukemia
  • Acute monocytic leukemia
  • Acute erythroid leukemia
  • Acute megakaryoblastic leukemia
  • Acute basophilic leukemia
  • Acute panmyelosis with myelofibrosis
  • Myeloid sarcoma

Each category represents a different type of cell that is affected by the cancer, and each type of leukemia has its own unique set of symptoms, treatment options, and prognosis.

AML with Recurrent Genetic Abnormalities

AML with recurrent genetic abnormalities is a type of leukemia characterized by specific genetic changes that affect the bone marrow cells. These genetic changes are considered to be the primary cause of AML, and they can be detected through various genetic tests.

At least 11 different recurring genetic abnormalities have been identified in AML, including translocations, inversions, and deletions. Some of the more well-known genetic abnormalities that can cause AML include the FLT3 gene mutation and the MLL gene rearrangement.

Patients with AML caused by recurrent genetic abnormalities may have a different prognosis than those with AML caused by other factors. Treatment options may also be different, depending on the specific genetic abnormality present.

AML with Myelodysplasia-Related Changes

AML with myelodysplasia-related changes is a type of leukemia that develops in patients with a history of myelodysplastic syndrome (MDS) or other myeloid disorders. MDS is a blood disorder characterized by a low number of blood cells in the bone marrow.

Patients with MDS are at an increased risk of developing AML. In fact, about one-third of patients with MDS eventually develop AML.

Patients with AML caused by myelodysplasia-related changes may have a poorer prognosis than those with other types of AML. Treatment options may also be limited, depending on the patient’s health status and the severity of the disease.

AML Not Otherwise Specified

AML not otherwise specified (NOS) is a type of leukemia that cannot be classified into any of the other categories of AML. This may be due to the fact that the cancer does not have any of the specific genetic abnormalities that are associated with AML, or it may be due to other factors.

Patients with AML NOS may have a different prognosis and treatment options than those with other types of AML. The specific treatment plan will depend on the patient’s overall health status, age, and the severity of the disease.

AML with Minimal Differentiation

AML with minimal differentiation is a type of leukemia characterized by a low number of mature white blood cells and a high number of immature blood cells in the bone marrow or blood.

Patients with AML with minimal differentiation may have a poorer prognosis than those with other types of AML. Treatment options may also be limited, depending on the patient’s health status and the severity of the disease.

AML Without Maturation

AML without maturation is a type of leukemia characterized by a high number of immature white blood cells in the bone marrow or blood. These immature cells do not develop into mature white blood cells, which can lead to a weakened immune system and an increased risk of infection.

Patients with AML without maturation may have a poorer prognosis than those with other types of AML. Treatment options may also be limited, depending on the patient’s health status and the severity of the disease.

Acute Myelomonocytic Leukemia

Acute myelomonocytic leukemia is a type of leukemia characterized by a high number of myeloid cells and monocytes in the bone marrow or blood.

Patients with acute myelomonocytic leukemia may have a different prognosis and treatment options than those with other types of AML. The specific treatment plan will depend on the patient’s overall health status, age, and the severity of the disease.

Acute Monocytic Leukemia

Acute monocytic leukemia is a type of leukemia characterized by a high number of monocytes in the bone marrow or blood. Monocytes are a type of white blood cell that help fight infection.

Patients with acute monocytic leukemia may have a different prognosis and treatment options than those with other types of AML. The specific treatment plan will depend on the patient’s overall health status, age, and the severity of the disease.

Acute Erythroid Leukemia

Acute erythroid leukemia is a type of leukemia characterized by a high number of immature red blood cells (erythroblasts) in the bone marrow or blood. These immature cells do not develop into mature red blood cells, which can lead to a decreased ability to carry oxygen throughout the body.

Patients with acute erythroid leukemia may have a different prognosis and treatment options than those with other types of AML. The specific treatment plan will depend on the patient’s overall health status, age, and the severity of the disease.

Acute Megakaryoblastic Leukemia

Acute megakaryoblastic leukemia is a type of leukemia characterized by a high number of megakaryocytes (platelet-forming cells) in the bone marrow or blood.

Patients with acute megakaryoblastic leukemia may have a different prognosis and treatment options than those with other types of AML. The specific treatment plan will depend on the patient’s overall health status, age, and the severity of the disease.

Acute Basophilic Leukemia

Acute basophilic leukemia is a type of leukemia characterized by a high number of basophils (a type of white blood cell) in the bone marrow or blood.

Patients with acute basophilic leukemia may have a different prognosis and treatment options than those with other types of AML. The specific treatment plan will depend on the patient’s overall health status, age, and the severity of the disease.

Acute Panmyelosis with Myelofibrosis

Acute panmyelosis with myelofibrosis is a rare type of leukemia characterized by abnormal growth of different types of blood cells in the bone marrow, along with the development of fibrous tissue in the bone marrow.

Patients with acute panmyelosis with myelofibrosis may have a poorer prognosis than those with other types of AML. Treatment options may also be limited, depending on the patient’s health status and the severity of the disease.

Myeloid Sarcoma

Myeloid sarcoma, also known as extramedullary leukemia, is a rare type of leukemia that affects other parts of the body, such as the skin, lymph nodes, or spleen. It is caused by the same cancerous cells that cause AML.

Patients with myeloid sarcoma may have a different prognosis and treatment options than those with other types of AML. The specific treatment plan will depend on the patient’s overall health status, age, and the severity of the disease.

How is AML Diagnosed?

AML can be diagnosed through a variety of tests, including:

  • Blood tests to measure the number of white blood cells, red blood cells, and platelets in the blood
  • Bone marrow biopsy to remove a small sample of bone marrow for examination under a microscope
  • Cytogenetic testing to examine the chromosomes in the bone marrow cells for genetic abnormalities
  • Molecular testing to detect specific gene mutations that may be responsible for the AML
  • Flow cytometry to analyze the cells in the bone marrow to determine the type of leukemia present

Once AML has been diagnosed, the patient’s doctor will work with the patient to create a treatment plan based on the type of AML present and the patient’s overall health status.

What Are the Treatment Options for AML?

The treatment options for AML may vary depending on the specific type of AML present, the patient’s overall health status, and the severity of the disease.

Some common treatment options for AML may include:

  • Chemotherapy, which uses drugs to kill cancer cells
  • Targeted therapy, which uses drugs or other treatments to specifically target the cancer cells
  • Bone marrow transplant, which involves replacing the patient’s bone marrow with healthy bone marrow from a donor

Depending on the specific type of AML present and the patient’s overall health status, doctors may also recommend other treatments or procedures.

Conclusion

AML is a type of cancer that can be fatal if not diagnosed and treated properly. The WHO classification of AML can help doctors better diagnose and treat the disease based on the specific type of AML present. Treatment options for AML may vary depending on the specific type of AML present, the patient’s overall health status, and the severity of the disease.

List of Common Questions and Answers

  • What is AML?
    AML is a type of blood cancer that affects the body’s production of white blood cells.
  • What is the WHO classification of AML?
    The WHO classification of AML is a system developed by the World Health Organization to help doctors better diagnose and treat the disease based on the specific type of AML present.
  • What are the different categories of AML?
    The different categories of AML include AML with recurrent genetic abnormalities, AML with myelodysplasia-related changes, AML not otherwise specified, AML with minimal differentiation, AML without maturation, acute myelomonocytic leukemia, acute monocytic leukemia, acute erythroid leukemia, acute megakaryoblastic leukemia, acute basophilic leukemia, acute panmyelosis with myelofibrosis, and myeloid sarcoma.
  • What are the most common diagnostic tests for AML?
    The most common diagnostic tests for AML include blood tests, bone marrow biopsy, cytogenetic testing, molecular testing, and flow cytometry.
  • What are the treatment options for AML?
    The treatment options for AML may include chemotherapy, targeted therapy, bone marrow transplant, and other treatments or procedures.

References

  • American Cancer Society. (2021). Acute Myeloid Leukemia (AML). Retrieved from https://www.cancer.org/cancer/acute-myeloid-leukemia/about/what-is-aml.html
  • National Cancer Institute. (2021). Adult Acute Myeloid Leukemia Treatment (PDQ)- Patient Version. Retrieved from https://www.cancer.gov/types/leukemia/patient/adult-aml-treatment-pdq
  • World Health Organization. (2017). Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th Edition). Retrieved from https://www.who.int/publications/i/item/9789283244943

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