Comparison of the WHO classification (5th edition) 2022 and the International Consensus Classification (ICC) 2022 for diagnosis of acute myeloid leukemia)

Abstract

In 2022, two classifications were published to define the diagnosis of patients with acute myeloid leukemia (AML). The World Health Organisation (WHO) 5th edition and the International Consensus Classification (ICC) provide an updated summary of current knowledge of the diseases and construct a framework for physicians. Two differing classifications result in discrepancies, which change the definition of AML subtypes and present a challenge in clinical settings. This work summarizes the updated classification systems and discusses their significance in clinical settings while considering the latest findings. Relevant changes affect the i) required blast percentage, ii) AML harbouring CEBPA mutations, iii) AML with KMT2A and MECOM rearrangements, iv) AML with myelodysplasia-related characteristics and in association with this entity AML with mutated RUNX1, and lastly v) AML with TP53 mutation. In summary, a unified classification system would be desirable to achieve harmonized diagnosis and treatment of AML).