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EHA 2026 | Insights into a study validating the ICC hierarchical classification in secondary AML
Maria Teresa Voso, MD, University Tor Vergata, Rome, Italy, shares insights from a study validating the International Consensus Classification (ICC) in secondary acute myeloid leukemia (AML). Dr Voso highlights that the genetic background, including cytogenetics and myelodysplasia-related mutations, is the major determinant of patient prognosis and identifies two distinct subgroups of myelodysplastic syndromes (MDS)-AML with different mutation patterns, confirming that stratification and treatment should follow genetics rather than prior patient history. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
So as we know the ICC was published in 2022 and is a new molecularly based or genetically based classification system and according to this new classification secondary AML are defined by the presence of myelodysplasia-related mutations or a previous history of MDS. While therapy-related AML are defined by the mutation status and therapy-related is only an attribute which is appended to the diagnosis of AML, given the previous history of cytotoxic chemotherapy to treat the patients...
So as we know the ICC was published in 2022 and is a new molecularly based or genetically based classification system and according to this new classification secondary AML are defined by the presence of myelodysplasia-related mutations or a previous history of MDS. While therapy-related AML are defined by the mutation status and therapy-related is only an attribute which is appended to the diagnosis of AML, given the previous history of cytotoxic chemotherapy to treat the patients. And we were able to confirm, of course, that the major determinant of patient prognosis is the genetic background, including cytogenetics and myelodysplasia-related mutations. And we were also interested in the subgroup of MDS, which is the MDS-AML subgroup with a proportion of blasts between 10 and 19%. And we were interested to see whether these may represent a continuum with MDS. And we were actually able to find two different patterns. One is there is a subgroup of MDS-AML which is characterized by AML type mutations NPM1 and FLT3 and a second subtype which is indeed characterized by myelodysplasia-related mutations. So, you know, we really, I mean, with a large independent case cohort, we confirm that stratification and treatment should follow genetics and not previous patient history.
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