Info

Classification

Lineage

Marker

Hematopoietic precursor Myeloid

CD117 (HLA-DR), CD34 CD11b, CD13, CD33, CD15

CD5, CD7, CD8, TdT CD10, CD19, CD20, CD21A, CD22, CD23, CD24, CD79a, TdT

Glycophorin A CD14, CD4, CD11b, CD11c, CD36, CD64

CD41, CD42, CD61

Hematopoietic precursor Myeloid

T-lineage

B-lineage

Erythroid Monocytic

Megakaryocytic

CD117 (HLA-DR), CD34 CD11b, CD13, CD33, CD15

CD5, CD7, CD8, TdT CD10, CD19, CD20, CD21A, CD22, CD23, CD24, CD79a, TdT

Glycophorin A CD14, CD4, CD11b, CD11c, CD36, CD64

CD41, CD42, CD61

thrombocythemia. The acute leukemias are categorized according to the cell line and stage of maturation that predominate. In order to classify the acute leukemias consistently, in 1976 the French-American-British (FAB) group developed a system of nomenclature that separated the acute myeloid from acute lymphoid leukemias. The classification scheme, as it evolved over the years, designates multiple subtypes for the various acute myeloid leukemias, M0 to M7, and three subtypes, L1 to L3, for the lymphoid leukemias (Table 11.6). The classification was initially based solely on morphology of the cells present; however, later results of cytochemistry staining reactions were incorporated into the classification. The requisite blast percentage derived from bone marrow examination using the FAB classification is greater than 30%.

The FAB classification has been problematic for several reasons. Immunophenotyping and cytogenic and molecular analyses are not well defined for the individual subtypes. Also, the FAB classification does not clearly separate groups of patients who have positive clinical outcomes. Because of these limitations, and due to the discovery of a number of genetic lesions that can predict clinical outcomes much better than just a morphology-based delineation, the group of hematopathologists convened by WHO in 1997 proposed a new classification for the acute myeloid leukemias (Table 11.7). The resulting scheme proposed by the WHO group incorporated specific genetic data into the classification of hematopoietic and lymphopoietic tumors24 (Table 11-8). They also included a sepa-

Table 11.6

O FAB Classification

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