Further correlations of morphology according to FAB and WHO classification to cytogenetics in de novo acute myeloid leukemia: a study on 2,235 patients

Abstract

In routine diagnostic procedures of acute myeloid leukemia (AML), the French-American-British (FAB) and World Health Organization (WHO) classifications both play a central role. Some morphologic subtypes are specifically associated to distinct cytogenetic and molecular aberrations; however, such close correlations do not exist for the majority of entities. We evaluated cytogenetics in 2,235 patients at diagnosis of AML with the FAB subtypes M0-2, M4, and M5-7. The cytogenetic patterns of these subtypes showed differences with respect to the clonal aberration rate and the incidence of complex aberrant karyotypes. The frequency of numerical gains and losses and of structural losses and the incidence of 11q23/MLL rearrangements differed. Thus, cytomorphology of AML may be helpful to support or even initiate other diagnostic procedures, e.g., interphase fluorescence in situ hybridization and polymerase chain reaction. In conclusion, the central role of morphology as defined by the FAB and WHO classification in AML at diagnosis is still justified in combination with other techniques.