Standardising acute myeloid leukaemia classification systems: a perspective from a panel of international experts

Rory M. Shallis, Naval Daver, Jessica K. Altman, Rami S. Komrokji, Daniel A. Pollyea, Talha Badar, Jan P. Bewersdorf, Vijaya R. Bhatt, Stéphane de Botton, Adolfo de la Fuente Burguera, Hetty E. Carraway, Pinkal Desai, Richard Dillon, Nicolas Duployez, Firas El Chaer, Amir T. Fathi, Sylvie D. Freeman, Ivana Gojo, Michael R. Grunwald, Brian A. JonasMarina Konopleva, Tara L. Lin, Gabriel N. Mannis, John Mascarenhas, Laura C. Michaelis, Alice S. Mims, Pau Montesinos, Olga Pozdnyakova, Keith W. Pratz, Andre C. Schuh, Mikkael A. Sekeres, Catherine C. Smith, Maximilian Stahl, Marion Subklewe, Geoffrey L. Uy, Maria Teresa Voso, Roland B. Walter, Eunice S. Wang, Joshua F. Zeidner, Andrius Žučenka, Amer M. Zeidan

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


The existence of two acute myeloid leukaemia classification systems—one put forth by WHO and one by the International Consensus Classification in 2022—is concerning. Although both systems appropriately move towards genomic disease definitions and reduced emphasis on blast enumeration, there are consequential disagreements between the two systems on what constitutes a diagnosis of acute myeloid leukaemia. This fundamental problem threatens the ability of heath-care providers to diagnose acute myeloid leukaemia, communicate with patients and other health-care providers, and deliver appropriate and consistent management strategies for patients with the condition. Clinical trial eligibility, standardised response assessments, and eventual drug development and regulatory pathways might also be negatively affected by the discrepancies. In this Viewpoint, we review the merits and limitations of both classification systems and illustrate how the coexistence, as well as application of both systems is an undue challenge to patients, clinicians, hematopathologists, sponsors of research, and regulators. Lastly, we emphasise the urgency and propose a roadmap, by which the two divergent classification systems can be harmonised.

Original languageEnglish (US)
Pages (from-to)e767-e776
JournalThe Lancet Haematology
Issue number9
StatePublished - Sep 2023

ASJC Scopus subject areas

  • Hematology


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