Acute Myeloid Leukemia (AML) Staging

Updated: Dec 30, 2020
Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD 

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 subtype

Name

Adult AML patients (%)

M0

Undifferentiated acute myeloblastic leukemia

5%

M1

Acute myeloblastic leukemia with minimal maturation

15%

M2

Acute myeloblastic leukemia with maturation

25%

M3

Acute promyelocytic leukemia

10%

M4

Acute myelomonocytic leukemia

20%

M4eos

Acute myelomonocytic leukemia with eosinophilia

5%

M5

Acute monocytic leukemia

10%

M6

Acute erythroid leukemia

5%

M7

Acute megakaryocytic leukemia

5%

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); CBFB-MYH11
  • APL with PML-RARA  (Acute promyelocytic leukemia with promyelocytic leukemia–retinoic acid receptor alpha) 
  • AML with t(9;11)(p21.3;q23.3); MLLT3-KMT2A
  • AML with t(6;9)(p23;q34.1); DEK-NUP214
  • AML with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM
  • AML (megakaryoblastic) with t(1;22)(p13.3;q13.3); RBM15-MKL1
  • Provisional entity: AML with BCR-ABL1
  • AML with mutated NPM1
  • AML with biallelic mutations of CEBPA
  • Provisional entity: AML with mutated RUNX1
  • AML with myelodysplasia-related changes
  • Therapy-related myeloid neoplasms

AML, not otherwise specified (NOS):

  • AML with minimal differentiation
  • AML without maturation
  • AML with maturation
  • Acute myelomonocytic leukemia
  • Acute monoblastic/monocytic leukemia
  • Pure erythroid leukemia
  • Acute megakaryoblastic leukemia
  • Acute basophilic leukemia
  • Acute panmyelosis with myelofibrosis

Myeloid sarcoma

Myeloid proliferations related to Down syndrome:

  • Transient abnormal myelopoiesis (TAM)
  • Myeloid leukemia associated with Down syndrome

Blastic plasmacytoid dendritic cell neoplasm

 

Questions & Answers

Overview

How is acute myeloid leukemia staged?

What is the FAB classification of acute myeloid leukemia?

What is the WHO classification of acute myeloid leukemia?