WHO classification of lymphoid malignancies
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Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України
2012
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| Zitieren: | WHO classification of lymphoid malignancies / D.F. Gluzman // Experimental Oncology. — 2012. — Т. 34, № 4. — С. 377-378. — Бібліогр.: 8 назв. — англ. |
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irk-123456789-1398722018-06-22T03:05:45Z WHO classification of lymphoid malignancies Gluzman, D.F. Conference reports 2012 Article WHO classification of lymphoid malignancies / D.F. Gluzman // Experimental Oncology. — 2012. — Т. 34, № 4. — С. 377-378. — Бібліогр.: 8 назв. — англ. 1812-9269 http://dspace.nbuv.gov.ua/handle/123456789/139872 en Experimental Oncology Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
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English |
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Conference reports Conference reports |
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Conference reports Conference reports Gluzman, D.F. WHO classification of lymphoid malignancies Experimental Oncology |
| format |
Article |
| author |
Gluzman, D.F. |
| author_facet |
Gluzman, D.F. |
| author_sort |
Gluzman, D.F. |
| title |
WHO classification of lymphoid malignancies |
| title_short |
WHO classification of lymphoid malignancies |
| title_full |
WHO classification of lymphoid malignancies |
| title_fullStr |
WHO classification of lymphoid malignancies |
| title_full_unstemmed |
WHO classification of lymphoid malignancies |
| title_sort |
who classification of lymphoid malignancies |
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Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
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2012 |
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Conference reports |
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http://dspace.nbuv.gov.ua/handle/123456789/139872 |
| citation_txt |
WHO classification of lymphoid malignancies / D.F. Gluzman // Experimental Oncology. — 2012. — Т. 34, № 4. — С. 377-378. — Бібліогр.: 8 назв. — англ. |
| series |
Experimental Oncology |
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AT gluzmandf whoclassificationoflymphoidmalignancies |
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2025-07-10T09:17:03Z |
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2025-07-10T09:17:03Z |
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1837250932689076224 |
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Experimental Oncology ��� �������� ���� ��ecem�er���� �������� ���� ��ecem�er� ��ecem�er� ���
MATERIALS OF HEMATOLOGY
TUTORIAL “DIAGNOSTIC
WORK-UP OF HEMATOLOGICAL
MALIGNANCIES. FOCUS ON LYMPHOID
MALIGNANCIES”,
MAY 18-19, 2012, KYIV, UKRAINE
For a�out �� years� the European School of Hema-
tology �ESH� and the European Hematology Associa-
tion �EHA� have cooperated in organizing educational
activities in the field of continuous medical education
designed in colla�oration with the international ex-
perts. ESH has worked much to improve and harmo-
nize the quality of education in hematology throughout
Europe with the active implication of the world’s most
prominent hematologists and hematology organiza-
tions. In ����� the Joint ESH-EHA Executive Commit-
tee was organized. The Committee mem�ers E. Gluck-
man and B. Lоwen�erg from ESH� W. Fi��e and R. Foa
from EHA have developed a framework for continuing
colla�oration in the field including the workshops and
training courses for hematologists. Among the scien-
tific and educational courses on the latest develop-
ments in hematology� the hematology tutorials are
of great interest for all those who are eager to improve
and update their knowledge in various fields of modern
hematology.
The scientific program of the tutorials comprising
plenary lectures� interactively conducted clinical case
study sessions and self-assessment sessions is de-
signed to encourage interaction �etween the faculty
and the course participants. For many years� within
the framework of ESH-EHA program for continuous
medical education� conferences� training courses and
la�oratory workshops have �een organized in various
countries throughout the world. The hematology tu-
torials involving a faculty of international experts are
targeted to clinicians� �iologists and students working
in the field of hematological malignancies.
It was the first time when the hematology tutorial
was held in Kyiv� Ukraine. The ��th Hematology Tutorial
promoted a modern view of morphology� pathogen-
esis� diagnosis and treatment of lymphoid malig-
nancies. The faculty of this tutorial consisted of the
leading experts from different countries: Prof. R. Foa
and Prof. G. Gaidano from Italy. Prof. C. �earden from
United Kingdom� Prof. S. McCann and Prof. E. Van-
den�erghe from Ireland� Prof. E. Kim�y from Sweden�
Prof. �. Gluzman and Prof. I. Kriachok from Ukraine.
Among the audience comprising a�out ��� people
were clinicians and researchers specializing in hema-
tology arriving from various cities throughout Ukraine.
As a courtesy of ESH-ESA and personally of the
faculty of the meeting� the lecturers have provided
their permissions for pu�lishing the extended a�-
stracts of their lectures in this issue of Experimental
Oncology.
WHO CLASSIFICATION OF LYMPHOID
MALIGNANCIES
D.F. Gluzman
R.E. Kavetsky Institute of Experimental Pathology,
Oncology and Radiobiology,
National Academy of Sciences of Ukraine
Correspondence: gluzman@onconet.kiev.ua
Lymphoid malignancies are tumors of the immune
system that originate from B or T lymphocytes and� rarely�
from NK cells. They encompass extremely heterogeneous
group of diseases �ased on their histological forms�
�iologic and molecular genetic features� sites of clinical
presentation �nodal or extranodal�� tumor �ehavior �local-
ized or disseminated�� and response to the treatment.
The history of recognition and classification of lym-
phoid malignancies is long� controversial and compli-
cated. Two classification systems have �een widely
used until recently� the Kiel classification of non-Hodg-
kin’s lymphomas and the Working Formulation for clinical
usage. In �99� after the immunologic revolution �creation
the hy�ridoma technology that led to the development
of monoclonal anti�odies� and dramatic progress in un-
derstanding the genetics of lymphoid malignancies��
the International Lymphoma Study Group �ILSG� of ex-
perienced hematologists formulated new proposals for
a modern lymphoma classification� the so-called Revised
European American Lymphoma �REAL� classification.
With some additions and corrections� it has �een devel-
oped into World Health Organization ������ classification
�E.S. Jaffe� N.L. Harris� H. Stein� J.W. Vardiman� eds.
Pathology and Genetics of Tumours of Haematopoietic
and Lymphoid Tissues. Lyon: IARC Press� ����. �5� p.�.
The �th edition of the WHO classification of Tumours
of Haematopoietic and Lymphoid Tissues ������ incor-
porates new information that has emerged from �asic
and clinical investigations and includes new defining
criteria for some diseases as well as num�er of new
entities defined �y a com�ination of immunopheno-
type� genetic criteria and clinical features.
The recent WHO classification ������ has �een
updated as a joint effort of more than ��� hemopatho-
gists from �� countries. WHO classification of the B cell�
T cell and NK cell neoplasms that in many respects re-
capitulate normal stage of lymphoid cell differentiation
su�dividing tumors into those with an immature or �las-
tic appearance versus more mature stage of lymphoid
development. This classification system represents
a significant advance in our a�ility to understand� iden-
tify and treat different lymphoma entities. It is �ased
on the concept of clinicopathologic entities in which
histology� immunophenotype� molecular genetic data
as well as clinical features are integrated. The putative
cell origin and stage of differentiation of different types
of lymphoid malignancies is also taken into account.
According to our experience� the application of im-
munocytochemical and molecular genetic studies has
led to the detection of small num�er of pathologic cells
Exp Oncol ����
��� �� �������
CONFERENCE REPORTS
��� Experimental Oncology ��� �������� ���� ��ecem�er�
in peripheral �lood and �one marrow of some patients
with non-Hodgkin’s lymphomas.
In �99�� the Reference La�oratory was set up as a pu�-
lic service on the �asis of the Immunocytochemistry
�epartment of R.E. Kavetsky Institute of Experimental
Pathology� Oncology and Radio�io logy� National Acad-
emy of Sciences of Ukraine with the aim of the precise
diagnosis of the haematopoietic malignancies �ased
on cytomorphology� cytoche mistry� immunophenotyping
and the techniques of molecular �iology in accordance
with FAB� WHO� EGIL� IC�-�� and IC�-O-� classifications.
The diagnostic activity of the Reference La�oratory covers
�5-�5% of all Ukrainian patients with acute leukemias�
chronic lymphoid and myeloid leukemias� myelodysplastic
syndromes� malignant lymphomas� histiocytosis� and
metastatic lesions of lymph nodes and �one marrow.
At present� the patients with tumors of haematopoietic and
lymphoid tissues are diagnosed according to up-to-date
WHO classification. We �elieve that only precise diagnosis
of the major types of hematological malignancies to the
up-to-date classification with delineation of the specific
�iological su�types of hematological malignancies may
represent the �asis for further molecular �iological and
epidemiological studies. New insight into the �iology of the
lymphoid malignancies in the coming years might well
improve our a�ility to evaluate patients and chose therapy.
REFERENCES
1. Ferry YA, Harris NL. Atlas of lymphoid hyperplasia
and lymphoma. Philadelphia: W.B. Saunders Co., 1997. 273 p.
2. Human lymphoma: clinical implications of the REAL
classification. D.Y. Mason, N.L. Harris (eds.). London
etc.: Springer-Verlag, 1999. 554 p.
3. World Health Organization classification of tumours.
Pathology and genetics of tumours of haematopoietic and lym-
phoid tissues. E.S. Jaffe, N.L. Harris, H. Stein, Y.W. Vardiman
(eds.). Lyon: IARC Press, 2001. 351 p.
4. Feller AC, Diebold J. Histopathology of nodal and
extranodal non-Hodgkin lymphoma. Berlin etc.: Springer-
Verlag, 2004. 464 p.
5. The lymphomas, 2nd ed. G.P. Canellos T.A. Lister,
B. Young (eds). Philadelphia: Elsevier Inc., 2006. 581 p.
6. WHO classification of tumours of haematopoietic and
lymphoid tissues. S.H. Swerdlow, E. Campo, N.L. Harris,
E.S. Jaffe, S.A. Pileri, H. Stein, J. Thiele, J.W. Vardiman
(eds.). Lyon: IARC Press, 2008. 439 p.
7. Gluzman DF, Sklyarenko LM, Nadgornaya VA. Tu-
mours of haematopoietic and lymphoid tissues (cytomor-
phology, immunocytochemistry, diagnostic algorithms).
Kyiv: DIA, 2008. 193 p. (in Russian)
8. Gluzman DF, Sklyarenko LM, Nadgornaya VA. Diag-
nostic oncohaematology. Kyiv: DIA, 2011. 256 p. (in Russian).
CHRONIC LYMPHOCYTIC LEUKEMIA
I.A. Kriachok
Oncohematology Department, National Cancer
Institute, Kyiv, Ukraine
Correspondence: irina.kryachok@unci.org.ua
Chronic lymphocytic leukemia �CLL� is the most com-
mon form of leukemia in Western countries with an inci-
dence of �.�/�������/year [�]. The incidence increases
to >��/�������/year at an age of >�� years. The median
age at diagnosis is �� years. A�out ��% of CLL patients
are reported to �e younger than 55 years.
The guidelines for the diagnosis and treatment
of chronic lymphocytic leukemia were revised �y the
International Workshop on CLL in ���� �IWCLL�. Crite-
ria for CLL are as follows: the presence in the peripheral
�lood of 5 x ��9/L monoclonal B lymphocytes for the
at least � months. The clonality of the circulating B lym-
phocytes needs to �e confirmed �y flow cyto metry [�].
Typical immunophenotype of CLL lymphocyte is C�5+�
C���+� C���+/-� C���-� C��9+� C��� dim� slgdim+ and
cyclin �I� [�]. Bone marrow examination is not required
for diagnosis and a CT scan not required for staging�
�ut flow cytometry is crucial for correct diagnosis.
The first prognostic marker to �e used in the
clinical management of CLL was the Rai clinical stag-
ing system� pu�lished in �9�5 [�]. This system was
later followed �y the Binet staging system� pu�lished
in �9�� [5]. Both of these staging systems provide
a �asic framework for estimating prognosis and are
factored into the current International Workshop
on CLL guidelines for initiation of treatment [�].
Multiple factors� measured in standard clinical la�-
oratory tests� affect the clinical course of CLL. These
factors include lymphocyte count� lymphocyte dou-
�ling time� M level� sTK level� angiopoietin-� �Ang-��
level� and solu�le cluster designation markers �C����
C���� and C��9d�. Other clinical markers that have
�een investigated as potential prognostic indicators
include age� gender [6]� lymphocyte dou�ling time [�]�
num�er of prolymphocytes [�]� pattern of �one mar-
row involvement and percentage of smudge cells [9].
Approximately ��% of individuals with CLL have
acquired chromosomal a�normalities within their
malignant clone and can �e categorized into five
prognostic groups accordingly: deletion ��q �median
survival� ��� months�; deletion ��q �median survival�
�9 months�; trisomy �� �median survival� ��� months�;
normal cytogenetics �median survival� ��� months�;
and deletion ��p �median survival� �� months�. Re-
ciprocal chromosome translocations are descri�ed
�ut are rare in CLL. A complex cytogenetic karyotype
can �e identified in ~I6% of patients and is commonly
associated with poor prognostic features including
C��� expression and unmutated IgHV [��].
The outcome of patients with leukemic cells that use
an unmutated IgVH gene is inferior to those patients with
leukemic cells that use a mutated IgVH gene. In addi-
tion� the VH�.�� gene usage is an unfavora�le prognos-
tic marker independent of the IgVH mutational status.
Leukemic cell expression of ZAP-�� and C��� was
found to correlate with the expression of unmutated
IgVH genes and to predict a poor prognosis.
However� the association �etween expression of ZAP-
�� or C��� with the expression of unmutated IgVH genes
is not a�solute. It is uncertain whether leukemia-cell
expression of unmutated IgVH genes or ZAP-�� pre-
dict the response to treatment or overall survival� once
therapy is required. Taken together� further clinical trials
are needed to standardize the assessment of these pa-
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