Acute Myeloid Leukemia Staging 

  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
 
Updated: Dec 30, 2015
 
 

FAB and WHO Classifications for Acute Myeloid Leukemia

Two staging systems are commonly used for acute myeloid leukemia (AML). The French-American-British (FAB) classification system is based on morphology to define specific immunotypes. The World Health Organization (WHO) classification reviews chromosome translocations and evidence of dysplasia.[1]

Table. FAB classification of AML (Open Table in a new window)

FAB subtypeNameAdult AML patients (%)
M0Undifferentiated acute myeloblastic leukemia5%
M1Acute myeloblastic leukemia with minimal maturation15%
M2Acute myeloblastic leukemia with maturation25%
M3Acute promyelocytic leukemia10%
M4Acute myelomonocytic leukemia20%
M4eosAcute myelomonocytic leukemia with eosinophilia5%
M5Acute monocytic leukemia10%
M6Acute erythroid leukemia5%
M7Acute megakaryocytic leukemia5%

WHO classification of AML and related neoplasms

AML with recurrent genetic abnormalities[2, 3] :

  • AML with t(8;21)(q22;q22); RUNX1-RUNX1T1
  • AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBEB-MYH11
  • Acute promyelocytic leukemia (APL) with t(15;17)(q22;q12); PML-RARA
  • AML with t(9;11)(p22;q23); MLLT3-MLL
  • AML with t(6;9)(p23;q34); DEK-NUP214
  • AML with inv(3)(q21q26.2) or t(3;3)(q21;q26.2); RPN1-EVI1
  • AML (megakaryoblastic) with t(1;22)(p13;q13); RBM15-MKL1
  • Provisional entity: AML with mutated NPM1
  • Provisional entity: AML with mutated CEBPA

AML with myelodysplasia-related change

Therapy-related myeloid neoplasms

AML, not otherwise specified:

  • Undifferentiated AML (M0)
  • AML with minimal differentiation (M1)
  • AML without maturation (M2)
  • AML with maturation (M2)
  • Acute myelomonocytic leukemia (M3)
  • Acute monoblastic/monocytic leukemia (M4)
  • Acute erythroid leukemia (M5)
  • Pure erythroid leukemia (M6)
  • Erythroleukemia, erythroid/myeloid (M6)
  • Acute megakaryoblastic leukemia (M7)
  • Acute basophilic leukemia
  • Acute panmyelosis with myelofibrosis

Myeloid sarcoma

Myeloid proliferations related to Down syndrome:

  • Transient abnormal myelopoiesis
  • Myeloid leukemia associated with Down syndrome

Blastic plasmacytoid dendritic cell neoplasm

 
Contributor Information and Disclosures
Author

Karen Seiter, MD Professor, Department of Internal Medicine, Division of Oncology/Hematology, New York Medical College

Karen Seiter, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, American Society of Hematology

Disclosure: Received honoraria from Novartis for speaking and teaching; Received consulting fee from Novartis for speaking and teaching; Received honoraria from Celgene for speaking and teaching.

Specialty Editor Board

Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Christopher D Braden, DO Hematologist/Oncologist, Chancellor Center for Oncology at Deaconess Hospital; Medical Director, Deaconess Hospital Outpatient Infusion Centers; Chairman, Deaconess Hospital Cancer Committee

Christopher D Braden, DO is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology

Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD Professor Emeritus, Department of Medicine, Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American Society of Clinical Oncology, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, New York Academy of Sciences

Disclosure: Nothing to disclose.

References
  1. How is acute myeloid leukemia classified?. American Cancer Society. Available at http://www.cancer.org/cancer/leukemia-acutemyeloidaml/detailedguide/leukemia-acute-myeloid-myelogenous-classified. December 9, 2014; Accessed: December 30, 2015.

  2. Vardiman JW, Harris NL, Brunning RD. The World Health Organization (WHO) classification of the myeloid neoplasms. Blood. 2002 Oct 1. 100(7):2292-302. [Medline].

  3. [Guideline] National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Acute Myeloid Leukemia Version 1.2015. Available at http://www.nccn.org/professionals/physician_gls/pdf/aml.pdf. Accessed: December 30, 2015.

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Table. FAB classification of AML
FAB subtypeNameAdult AML patients (%)
M0Undifferentiated acute myeloblastic leukemia5%
M1Acute myeloblastic leukemia with minimal maturation15%
M2Acute myeloblastic leukemia with maturation25%
M3Acute promyelocytic leukemia10%
M4Acute myelomonocytic leukemia20%
M4eosAcute myelomonocytic leukemia with eosinophilia5%
M5Acute monocytic leukemia10%
M6Acute erythroid leukemia5%
M7Acute megakaryocytic leukemia5%
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