Major clinically relevant differences among ELN 2022, fifth edition of the WHO, and the ICC 2022 of myeloid neoplasms
| . | ELN 2022 & ICC 2022 . | WHO fifth edition . |
|---|---|---|
| MDS/AML (without AML-defining genetic alterations) | 10%-19% blasts | Designated as MDS-IB2 (10%-19% bone marrow or 5%-19% peripheral blood or Auer rods) |
| AML with antecedent MDS, MDS/MPN, or prior exposure to therapy | Myelodysplasia added as a diagnostic qualifier | Included as a separate entity, AML-MR |
| AML with NPM1 mutations, KMT2A rearrangement, MECOM rearrangement, and NUP98 rearrangement | Requires ≥10% blasts in bone marrow or peripheral blood | Can be diagnosed irrespective of blast count |
| AML with CEBPA mutation | Requires ≥10% blasts in bone marrow or peripheral blood Includes only bzip mutations | Requires ≥20% blasts in bone marrow or peripheral blood Includes biallelic and bzip mutations |
| TP53 mutation | Included separately in the hierarchical classification | Not included as a separate entity for AML |
| Therapy-related | Added as a diagnostic qualifier | Included as separate entity AML-pCT |
| . | ELN 2022 & ICC 2022 . | WHO fifth edition . |
|---|---|---|
| MDS/AML (without AML-defining genetic alterations) | 10%-19% blasts | Designated as MDS-IB2 (10%-19% bone marrow or 5%-19% peripheral blood or Auer rods) |
| AML with antecedent MDS, MDS/MPN, or prior exposure to therapy | Myelodysplasia added as a diagnostic qualifier | Included as a separate entity, AML-MR |
| AML with NPM1 mutations, KMT2A rearrangement, MECOM rearrangement, and NUP98 rearrangement | Requires ≥10% blasts in bone marrow or peripheral blood | Can be diagnosed irrespective of blast count |
| AML with CEBPA mutation | Requires ≥10% blasts in bone marrow or peripheral blood Includes only bzip mutations | Requires ≥20% blasts in bone marrow or peripheral blood Includes biallelic and bzip mutations |
| TP53 mutation | Included separately in the hierarchical classification | Not included as a separate entity for AML |
| Therapy-related | Added as a diagnostic qualifier | Included as separate entity AML-pCT |
bzip, basic leucine zipper; MDS, myelodysplasia; MDS-IB2, MDS with increased blasts; MPN, myeloproliferative neoplasm; pCT, post cytotoxic therapy.