Updated WHO Classification of Hematologic Malignancies


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The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Dr. Abutalib tests your knowledge of the 2016 revisions to the World Health Organization (WHO) classification of hematologic malignancies.

WHO last updated its classification of tumors of hematopoietic and lymphoid tissues with a fourth edition of its WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, in 2008, as part of a series of WHO Classification of Tumours monographs. This year, with the support of the International Agency for Research on Cancer, WHO is publishing an updated revision of the fourth edition that has incorporated new data from the past 8 years.

For each question, select one best answer. Answers appear with expert commentary → .

Question 1

Which statement about the classification of tumors of hematopoietic and lymphoid tissues is true?

A. The revised WHO classification defines distant disease entities that can be reliably diagnosed using proposed criteria.

B. The revised WHO classification is limited by the addition of newer genetic data.

C. The revised WHO classification only considers pathology data to diagnose hematologic malignancies.

Question 2

Which statement about the 2016 revisions to the WHO classification of myeloid neoplasms and acute leukemia is correct?

A. CSF3R mutation can be checked to diagnose atypical chronic myeloid leukemia.

B. A section about germline predisposition to myeloid neoplasms has been added to the revised WHO ­classification.

C. SF3B1 mutation can be checked to diagnose a subtype of a myeloproliferative neoplasm.

Syed A. Abutalib, MD

Syed A. Abutalib, MD

GUEST EDITOR

Syed A. Abutalib, MD, Assistant Director, Hematology & Bone Marrow Transplantation Service, Cancer Treatment Centers of America, Zion, Illinois

Question 3

Which statement about the 2016 revision of the WHO classification of lymphoid neoplasms specific for monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) is correct?

A. Cytopenias are sufficient to make a diagnosis of CLL with < 5 × 109/L peripheral blood CLL cells.

B. The natural course of monoclonal B-cell lymphocytosis is homogeneous across all patients.

C. The revised WHO classification added “proliferation centers” as a significant and independent adverse prognostic indicator in CLL/SLL.

Question 4

Which statement about the 2016 revision of the World Health Organization classification of lymphoid neoplasms is correct?

A. All cases of mantle cell lymphoma express SOX11.

B. BRAF V600E mutations are found in almost all cases of hairy cell leukemia.

C. MYD88 L265P mutations are seen exclusively in lymphoplasmacytic lymphoma.


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Updated WHO Classification of Hematologic Malignancies: Answers

Question 1: Which statement about the classification of tumors of hematopoietic and lymphoid tissues is true?

Correct Answer: A. The revised WHO classification defines distant disease entities that can be reliably diagnosed using proposed criteria.

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