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The 5th edition of WHO Heme malignancy: myeloid neoplasms
4th edition was in 2017.
Clonal hematopoiesis: CHIP and CCUS are formally defined, VAF >=2%
Cytopenias: Hgb <13 for men, <12 for female, ANC< 1.8 , plt <150
CML: removed accelerated phase. Chronic phase, 10-yr OS of 80-90%
MDS is now called myelodysplatic neoplasms:
--threshold for dysplasia is set at 10%
--having defining genetic abn: MDS w/ low basts and isolated 5q, MDS w/ low blasts and SF3B1, MDS w/ biallelic TP53 inactivation
--vs morphologically define: MDS w/ low blasts, MDS hypoplastic (<25% cellulariy, age adjusted), MDS-IB1, MDS-IB2 (auer rods), MDS w/ fibrosis
CMML had major revisions
--monocytosis >500, 1 lineage dysplasia, clonal cytogenetics/molecular
--CMML (no more -0, -1)
--MDS/MPS w/ neutrophilia
--MDS/MPN w/ SF3B1 mutation and thrombocytosis
--MDS/MPN not otherwise specified
ref: Leukemia. 2022 Jul;36(7):1703-1719.
The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms