Leukemia Classification

For all newly diagnosed patients with leukemia, an aspirate of the liquid marrow and a bone marrow core biopsy are obtained.5 Morphologic and cytochemical analyses of these samples distinguish three subtypes of ALL (L1, L2, and L3) and eight subtypes of AML (M0-M7) as classified by the French-American-British (FAB) scheme. See Tables 95-2 and 95-3 for the FAB classification of AML and ALL. Another classification system proposed by the World Health Organization (WHO) and the Society of Hematopathology for myeloid neoplasms includes not only morphologic findings, but also genetic, immunophenotypic, biological, and clinical characteristics (Table 95-4).

A disadvantage of this system is that it does not account for some of the myeloid disorders in pediatrics.6

Table 95-2 Morphologic (FAB) Classification of AML

Fiequency of t AB Subtype'

Table 95-2 Morphologic (FAB) Classification of AML

Fiequency of t AB Subtype'

Children Older Than

Children Younger

Subtype

Adulun)

2 rein m

Thin 2 Yfclri [*)

MO

Acute myeloblast«: leukemia, without maturation

Low

lew

Mi

Acute myelohlaiHr leukemia wlrh minimal

J5

"laluiatbn

M2

Acute myekiilatflc leukemia with maiurilkm

2S

M3

Aiu» pionnttxyli: leuki«iLi

B

U4

At utc myelOflWHotyllc leuktuu

S

M 5a

Acute monohlauiir Ifulemla, poorty dffe<em ialed

S

S3

Aiuw monobtaifc Kuiefirife wctmjififfimniHf

i

M6

Atutt ciythrotculiLTTiki

s

2

M7

Acute megakaryobli-btlc leukemia

10

S-7

FAB, Frereh-AjnerlcaiYli<liish.

'Perterldgei ihcuW be tempered w Ikjlv ¿"J not

MapKd foam ftcf. 6.

FAB, Frereh-AjnerlcaiYli<liish.

'Perterldgei ihcuW be tempered w Ikjlv ¿"J not

MapKd foam ftcf. 6.

Table 95-3 Morphologic (FAB) Classification and Immunophenotype of ALL

Frequency of FAB Subtype3

Subtype

Cell of Origin

Adults m

Children {%)

LI

Early pre-Bcell Pre-B ceil B cell T cell

30

85

11

Early pre-Bcell Pre B coll 6 cell T cell

60

14

L3

E ceil

to

1

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