Subtypes of Childhood Acute Myeloid Leukemia

Executive Summary

Childhood acute myeloid leukaemia classification depends upon their similarity with healthy immature bone marrow blast cells and genetic and molecular testing of the leukaemia cells. Childhood AML consists of eight major subtypes as per the FAB classification scheme using classification from M0 to M7. The subtypes of childhood acute myeloid leukemia include Acute myeloid leukaemia with recurrent genetic abnormalities, Acute promyelocytic leukaemia (APL) with PML-RARA, AML with t(9;11)(p22;q23); MLLT3-KMT2A, AML with t(8;21)(q22;q22); RUNX1-RUNX1T1, AML with inv(3)(q21q26.2) or t(3;3)(q21;q26.2); GATA2, MECOM, AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBFB-MYH11, AML with biallelic mutations of CEBPα, AML with t(6;9)(p23;q34); DEK-NUP214, AML with mutated NPM1, AML (megakaryoblastic) with t(1;22)(p13;q13); RBM15-MKL1, Acute myeloid leukaemia with myelodysplasia-related changes, Therapy-related myeloid neoplasms, Acute myeloid leukaemia, not otherwise specified, AML with minimal differentiation, AML without maturation, AML with maturation, Acute myelomonocytic leukaemia, Acute monoblastic/monocytic leukaemia, Pure erythroid leukaemia, Acute megakaryoblastic leukaemia, Acute basophilic leukaemia, Acute panmyelosis with myelofibrosis, Myeloid sarcoma, Myeloid proliferations related to Down syndrome, Transient abnormal myelopoiesis (TAM), and Myeloid leukaemia associated with Down syndrome.

Subtypes of Childhood Acute Myeloid Leukemia

Classification is based on how much they resemble healthy immature bone marrow blast cells, and recently, on the genetic and molecular testing of the leukaemia cells ​1​. In the recent past, AML was classified into eight major subtypes according to a system known as the FAB classification scheme, using levels M0 to M7, and was primarily based on their appearance under a microscope. Presently, a method of subtyping AML is used that first considers the cytogenetic causes of AML. This is called the World Health Organization 2016 classification.

Subtypes ​2​:

  • Acute myeloid leukaemia with recurrent genetic abnormalities
  • Acute promyelocytic leukaemia (APL) with PML-RARA
  • AML with t(9;11)(p22;q23); MLLT3-KMT2A
  • AML with t(8;21)(q22;q22); RUNX1-RUNX1T1
  • AML with inv(3)(q21q26.2) or t(3;3)(q21;q26.2); GATA2, MECOM
  • AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBFB-MYH11
  • AML with biallelic mutations of CEBPα
  • AML with t(6;9)(p23;q34); DEK-NUP214
  • AML with mutated NPM1
  • AML (megakaryoblastic) with t(1;22)(p13;q13); RBM15-MKL1
  • Acute myeloid leukaemia with myelodysplasia-related changes
  • Therapy-related myeloid neoplasms
  • Acute myeloid leukaemia, not otherwise specified
  • AML with minimal differentiation
  • AML without maturation
  • AML with maturation
  • Acute myelomonocytic leukaemia
  • Acute monoblastic/monocytic leukaemia
  • Pure erythroid leukaemia
  • Acute megakaryoblastic leukaemia
  • Acute basophilic leukaemia
  • Acute panmyelosis with myelofibrosis
  • Myeloid sarcoma
  • Myeloid proliferations related to Down syndrome
  • Transient abnormal myelopoiesis (TAM)
  • Myeloid leukaemia associated with Down syndrome

References

  1. 1.
    Obulkasim A, Katsman-Kuipers JE, Verboon L, et al. Classification of pediatric acute myeloid leukemia based on miRNA expression profiles. Oncotarget. Published online March 23, 2017:33078-33085. doi:10.18632/oncotarget.16525
  2. 2.
    Danen-van Oorschot AA, Kuipers JE, Arentsen-Peters S, et al. Differentially expressed miRNAs in cytogenetic and molecular subtypes of pediatric acute myeloid leukemia. Pediatr Blood Cancer. Published online August 4, 2011:715-721. doi:10.1002/pbc.23279