Classification is thelanguage of medicine: diseases must be described, defined and named before they
can be diagnosed, treated and studied. However, a critical feature of any
classification of diseases is that it be periodically reviewed and updated to incorporate
new information. For many
years the diagnosis of leukemia was based solely on pathologic and cytological
examination of bone marrow and peripheral blood smears; however, this
classification does not always reflect the genetic and clinical diversity of
the disease. In this way, the World Health Organization (WHO) proposed a
classification to recognize and classify different subgroups of leukemia
through clinical, morphological and genetic correlation.
The “WHO
Classification of Tumours of Haematopoietic and Lymphoid Tissues” is one of the
“blue book” monographs published by the International Agency for Research on
Cancer (IARC; Lyon, France), created in collaboration with the Society for
Hematopathology and the European Association for Haematopathology. Eight years
have elapsed since the current fourth edition of the monograph was published in
2008, and remarkable progress has been made in the field in this time period.
Despite this, a truly new fifth edition cannot be published for the time being,
as there are still other volumes pending in the fourth edition of the WHO tumor
monograph series. Therefore, the Editors of the “WHO Classification of Tumours
of Haematopoietic and Lymphoid Tissues,” with the support of the IARC and the
WHO, decided to publish an updated revision of the fourth edition that would
incorporate new data from the past 8 years which have important diagnostic,
prognostic, and therapeutic implications.
The major
changes in the classification and their rationale are presented by Swerdlow S.
et al. and Arber D. et al. for lymphoid and myeloid neoplasm
respectively, however it’s important to note that although some provisional
entities have been promoted to definite entities and a few provisional entities
have been added to the revised WHO classification, no new definite entities
were permitted according to IARC guidelines. The current
revision is a much needed and significant update of the 2008 WHO
classificationto incorporate clinical features, morphology, immunophenotyping,
cytogenetics, and molecular genetics to provide better diagnostic categories
and criteria, together with biological and clinical correlates, and facilitate
state-of-theart patient care, future therapeutic advances, and basic research
in this field. The WHO effort to keep up-dating the classification will
continue on, and hopefully provide a model of cooperation between clinicians,
pathologists, scientists and hematologists from all over the world. In the field
of leukemia, many questions remain unanswered, however, this update is the
first step toward a closer integration of genetic data into a
clinicopathological classification. Based in this, the journal “Austin
Leukemia” aims to promote research communications and provide a forum for
doctors, researchers, physicians and healthcare professionals to find most
recent advances in all areas of Leukemia that could be the basis for future
classifications.
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