Diagnostic Approach for Acute Myeloid Leukemia Based on the World Health Organization Classification of Hematologic Neoplasms

Abstract

Acute myeloid leukemias (AMLs) are heterogeneous hematologic neoplasms characterized by myeloblast or promyelocyte proliferation without normal differentiation. The World Health Organization (WHO) classifies AMLs on the basis of chromosomal and genetic aberrations, with different prognoses for each subtype. Therefore, accurate diagnosis and classification of AMLs is critical for timely and appropriate treatment. Initial diagnostic workup includes morphologic assessment of the bone marrow aspirate and trephine biopsies, immunophenotyping using flow cytometry or immunohistochemistry stains, chromosomal analysis using the G-banding technique or fluorescence in situ hybridization, and mutation analysis using polymerase chain reaction, direct sequencing, or next-generation sequencing. The present study provides an algorithm for AML diagnosis and classification based on the WHO criteria and describes different clinicopathological stages of the workup.