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EBMT 2026 | Revisiting the WHO and ICC 2022 scores for AML and MDS: addressing differences between the systems
In this video, Francesco Buccisano, MD, University of Rome Tor Vergata, Rome, Italy, outlines the differences between the WHO and ICC 2022 scores for classifying and risk-stratifying patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Dr Buccisano discusses how blood counts and genetics are used to classify disease and highlights the importance of consolidating these two major classification systems. This interview took place at the 52nd Annual Meeting of the EBMT in Madrid, Spain.
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Transcript
Well, I would say that the most striking difference is the level of blood cells in the bone marrow that define acute myeloid leukemia, because ICC has created an intermediate category called MDS-AML that actually is part of the AML world. So in theory, we are allowed to treat as AML also patients with more than 10% blasts that in our previous experience were considered as high-risk MDS...
Well, I would say that the most striking difference is the level of blood cells in the bone marrow that define acute myeloid leukemia, because ICC has created an intermediate category called MDS-AML that actually is part of the AML world. So in theory, we are allowed to treat as AML also patients with more than 10% blasts that in our previous experience were considered as high-risk MDS. WHO 2022 has kept the level of 20% to define an AML, even if in some specific genetic categories it has abrogated the idea of blast count because it’s the genetics that defines every subgroup of AML, but I would say that is the most striking difference.
For sure, we are increasing day by day our knowledge on the genetic profiling of AML and MDS because we have a very in-depth analysis by whole-genome sequencing. So I do believe that what we are actively reviewing is the genetic profile of every AML subset. Even if I would like the consortia to review the discrepancy among the two different classifications to at the end reach a harmonized version of the classification that is very useful for doctors but also allows us better communication with patients.
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Disclosures
Jazz, Menarini, Servier.
