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World Health Organization Classification of Neoplastic Diseases of the Hematopoietic and Lymphoid Tissues: Report of the Clinical Advisory Committee Meeting—Airlie House, Virginia, November 1997

From the Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA; National Cancer Institute, Bethesda, MD; Hotel Dieu and Hopital Necker, Paris, France; University of Wurzburg, Wurzburg, Germany; Pritzker School of Medicine, University of Chicago, Chicago, IL, Department of Medical Oncology, St Bartholomew's Hospital, London, UK; and Ohio State University Comprehensive Cancer Center, Columbus, OH.

Address reprint requests to Nancy Lee Harris, MD, Pathology, Warren 2, Massachusetts General Hospital, Fruit St, Boston, MA 02114; email nlharris{at}partners.org

PURPOSE: The European Association of Hematopathologists and the Society for Hematopathology have developed a new World Health Organization (WHO) classification of hematologic malignancies, including lymphoid, myeloid, histiocytic, and mast cell neoplasms.

DESIGN: Ten committees of pathologists developed lists and definitions of disease entities. A clinical advisory committee (CAC) of international hematologists and oncologists was formed to ensure that the classification would be useful to clinicians. The CAC met in November 1997 to discuss clinical issues related to the classification.

RESULTS: The WHO uses the Revised European-American Lymphoma (REAL) classification, published in 1994 by the International Lymphoma Study Group, to categorize lymphoid neoplasms. The REAL classification is based on the principle that a classification is a list of "real" disease entities, which are defined by a combination of morphology, immunophenotype, genetic features, and clinical features. The relative importance of each of these features varies among diseases, and there is no one gold standard. The WHO classification applies the principles of the REAL classification to myeloid and histiocytic neoplasms. The classification of myeloid neoplasms recognizes distinct entities defined by a combination of morphology and cytogenetic abnormalities. At the CAC meeting, which was organized around a series of clinical questions, participants reached a consensus on most of the questions posed. They concluded that clinical groupings of lymphoid neoplasms were neither necessary nor desirable. Patient treatment is determined by the specific type of lymphoma, with the addition of grade within the tumor type, if applicable, and clinical prognostic factors, such as the International Prognostic Index.

CONCLUSION: The WHO classification has produced a new and exciting degree of cooperation and communication between oncologists and pathologists from around the world, which should facilitate progress in the understanding and treatment of hematologic malignancies.

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				S. P. Treon, Z. R. Hunter, J. Matous, R. M. Joyce, B. Mannion, R. Advani, D. Cook, J. Songer, J. Hill, B. R. Kaden, et al. Multicenter Clinical Trial of Bortezomib in Relapsed/Refractory Waldenstrom's Macroglobulinemia: Results of WMCTG Trial 03-248 Clin. Cancer Res., June 1, 2007; 13(11): 3320 - 3325. [Abstract] [Full Text] [PDF]

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				O. Bruserud, A. Ryningen, A. M. Olsnes, L. Stordrange, A. M. Oyan, K. H. Kalland, and B. T. Gjertsen Subclassification of patients with acute myelogenous leukemia based on chemokine responsiveness and constitutive chemokine release by their leukemic cells Haematologica, March 1, 2007; 92(3): 332 - 341. [Abstract] [Full Text] [PDF]

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				A. Koster, H. A. Tromp, J. M.M. Raemaekers, G. F. Borm, K. Hebeda, M. A. MacKenzie, and J. H.J.M. van Krieken The prognostic significance of the intra-follicular tumor cell proliferative rate in follicular lymphoma Haematologica, February 1, 2007; 92(2): 184 - 190. [Abstract] [Full Text] [PDF]

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				J. Pijpe, W. W. I. Kalk, J. E. van der Wal, A. Vissink, Ph. M. Kluin, J. L. N. Roodenburg, H. Bootsma, C. G. M. Kallenberg, and F. K. L. Spijkervet Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome Rheumatology, February 1, 2007; 46(2): 335 - 341. [Abstract] [Full Text] [PDF]

				A. Ganser, M. A. Morgan, and E. M. Weissinger Going from genes to proteins in myelodysplastic syndromes PNAS, January 23, 2007; 104(4): 1109 - 1110. [Full Text] [PDF]

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				M. K. Middleton, A. M. Zukas, T. Rubinstein, M. Jacob, P. Zhu, L. Zhao, I. Blair, and E. Pure Identification of 12/15-lipoxygenase as a suppressor of myeloproliferative disease J. Exp. Med., October 30, 2006; 203(11): 2529 - 2540. [Abstract] [Full Text] [PDF]