who classification of tumours, 5th edition pdfwho classification of tumours, 5th edition pdf

2012;120:245465. MDS/MPN with ring sideroblasts and thrombocytosis redefined based on SF3B1 mutation and renamed MDS/MPN with SF3B1 mutation and thrombocytosis. Juvenile myelomonocytic leukaemia (JMML) is a haematopoietic stem cell-derived myeloproliferative neoplasm of early childhood. Yoshizato T, Dumitriu B, Hosokawa K, Makishima H, Yoshida K, Townsley D, et al. Myeloproliferative neoplasms (MPN) are listed in Table1. 100Division of Hematopathology, Department of Cellular Pathology, The Royal London Hospital. Hematopoietic neoplasms with 9p24/JAK2 rearrangement: a multicenter study. This paper summarizes the new WHO classification scheme for m Blood. Clinical features include congenital anomalies, bone marrow failure, and cancer predisposition [107]. N Engl J Med. Cytopathology reporting uses a hierarchial system of diagnostic categories. Am J Clin Pathol. Cases with a de novo molecular signature such as NPM1 mutation and core-binding factor leukaemias should still be assigned to this category since the post cytotoxic therapy designation is based on the medical history, and the indication of the most specific diagnosis in the pathology report is recommended when possible. Indeed, the recent identification of BCL11B rearrangements in MPAL T/Myeloid, ETP-ALL, acute leukaemia of ambiguous lineage (ALAL) and a subset of AML with minimal differentiation suggests a biologic continuum across these entities, a finding with likely implications on future editions of the classification [58,59,60,61]. 2017;129:322736. Blood Cancer J. Baran and Dawbers Diseases of the Nails and their Management 5th edition PDF Download: Baumanns Cosmetic Dermatology 3rd Edition PDF Download: Scher and Daniels Nails: Diagnosis, Surgery, Therapy 4th Edition PDF Download: Local Flaps in Facial Reconstruction 4th Edition PDF Download: Plastic Surgery: 6-Volume Set 5th Edition PDF Download: Lippincott Physiology PDF Download LINK [2020 Edition]: Anatomy and Physiology Textbook PDF Free Download:2023. lippincott Biochemistry 7TH EDITION PDF DOWNLOAD LINK: BRS Biochemistry PDF 7th Edition DOWNLOAD:2023, Critical Care Nursing: Diagnosis and Management PDF 8th Edition [Direct Link] - Medical Students Corner, Daviss Drug Guide For Nurses PDF 17th Edition Free Download:2023. The other subtype is ALAL with BCL11B rearrangement, which has a more heterogenous immunophenotype - identified in acute undifferentiated leukaemia (AUL) and ~20-30% of T/myeloid MPAL. This multi-hit mutational status results in a neoplastic clone that lacks any residual wild-type p53 protein. Chakraborty R, Abdel-Wahab O, Durham BH. 83Developmental Biology and Cancer Department, University College London Great Ormond Street Institute of Child Health; Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom. Published: Oct 16, 2022 DOI: https://doi.org/10.36255/exon-publications-leukemia-who-5th-edition-hematolymphoid-tumors Keywords: 5th edition of the WHO classification of hematolymphoid tumors, hematolymphoid tumors, hematopoietic neoplasm, lymphoid neoplasm Weijie Li, MD, PHD Article TP53 mutation status divides myelodysplastic syndromes with complex karyotypes into distinct prognostic subgroups. The genetic landscape of cMDS-IB and cMDS-LB is similar, and they both differ from MDS arising in adults. New developments in diagnosis, prognostication, and treatment of advanced systemic mastocytosis. CAS Biology and prognostic impact of clonal plasmacytoid dendritic cells in chronic myelomonocytic leukemia. 85Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Soverini S, Bavaro L, De Benedittis C, Martelli M, Iurlo A, Orofino N, et al. Myeloproliferative neoplasm with eosinophilia and T-lymphoblastic lymphoma with ETV6-LYN gene fusion. Erratum in Blood. (Table11) These BCR::ABL1-negativediseases have long been recognized in view of their distinctive clinicopathologic features and sensitivity to TKI. Cancer in children with fanconi anemia and ataxia-telangiectasia-a nationwide register-based cohort study in Germany. [59,60,61, 80] These different types of acute leukaemias with stem cell, myeloid, and T-ALL features having BCL11B rearrangement in common suggests a biological continuum. Highlights of the management of adult histiocytic disorders: langerhans cell histiocytosis, erdheim-chester disease, rosai-dorfman disease, and hemophagocytic lymphohistiocytosis. The blast cutoff requirement is needed for the former to avoid overlap with CML. Wang W, Wang SA, Medeiros LJ, Khoury JD. A threshold of >10% for myeloperoxidase positivity seems to improve specificity [81], but no consensus cutoff has been established. Myeloid neoplasms in RASopathies involve MAPK hyperactivation, leading to myeloid cell proliferation [110]. MP-CMML is commonly associated with activating RAS pathway mutations and adverse clinical outcomes [51]. This paper summarizes the new WHO classification scheme for myeloid and histiocytic/dendritic neoplasms and provides an overview of the principles and rationale underpinning changes from the prior edition. 2021 WHO Classification of Tumors of the Central Nervous System: a Greenland NY, Van Ziffle JA, Liu YC, Qi Z, Prakash S, Wang L. Genomic analysis in myeloid sarcoma and comparison with paired acute myeloid leukemia. Malcovati L, Stevenson K, Papaemmanuil E, Neuberg D, Bejar R, Boultwood J, et al. Blood. J Clin Oncol. There is insufficient data to support any change in the blast cutoff criterion for AML with CEBPA mutation [54, 55]. Leukemia. This series (also known as the WHO Blue Books) is regarded as the gold standard for the diagnosis of tumours and comprises a unique synthesis of histopathological diagnosis with digital and molecular . 66Department of Pathology, Bambino Ges Childrens Hospital, IRCCS, Rome, Italy. The result is an enhanced, contemporary, evidence-based classification of myeloid and histiocytic/dendritic neoplasms, rooted in molecular biology and an organizational structure that permits future scalability as new discoveries continue to inexorably inform future editions. 2021;34:101329. van den Ancker W, Westers TM, de Leeuw DC, van der Veeken YF, Loonen A, van Beckhoven E, et al. WHO Classification of Tumours Publishes 5th Edition, Volume 8 - UAB Pericart S, Waysse C, Siegfried A, Struski S, Delabesse E, Laurent C, et al. The upcoming 5th edition of the World Health Organization (WHO) Classification of Haematolymphoid Tumours is part of an effort to hierarchically catalogue human cancers arising in various organ systems within a single relational database. Blood. Best Pract Res Clin Haematol. Nature. N Engl J Med. Primary myelofibrosis (PMF) is characterized by a proliferation of abnormal megakaryocytes and granulocytes in the bone marrow, which is associated in fibrotic stages with a polyclonal increase in fibroblasts that drive secondary reticulin and/or collagen marrow fibrosis, osteosclerosis, and extramedullary haematopoiesis. Haase D, Stevenson KE, Neuberg D, Maciejewski JP, Nazha A, Sekeres MA, et al. Prognostic significance of pronormoblasts in erythrocyte predominant myelodysplastic patients. Diagnostic criteria for other MDS/MPN types were largely unchanged. Haferlach T, Nagata Y, Grossmann V, Okuno Y, Bacher U, Nagae G, et al. The majority of MLN-TK cases associated with PDGFRA rearrangements have cytogenetically cryptic deletion of 4q12 resulting in FIP1L1::PDGFRA, but PDGFRA fusions involving other partners are also identified. [Updated WHO classification of tumors of the breast: the most - PubMed 2017;377:23989. Notwithstanding, categorizing AML cases lacking defining genetic abnormalities based on differentiation offers a longstanding classification paradigm with practical, prognostic, and perhaps therapeutic implications. and transmitted securely. Response to tyrosine kinase inhibitors in myeloid neoplasms associated with PCM1-JAK2, BCR-JAK2 and ETV6-ABL1 fusion genes. The natural history of MLN-TK with PDGFRA or PDGFRB has been dramatically altered by TKI therapy, particularly imatinib. WHO Classification of Tumours Online - World Health Organization Approximately 80% of cases show hypocellular bone marrow with features similar to severe aplastic anemia and other BMFS, requiring close morphologic examination to evaluate the distribution, maturation, and presence of dysplasia in haematopoietic lineages [42]. Germline predisposition in myeloid neoplasms: Unique genetic and clinical features of GATA2 deficiency and SAMD9/SAMD9L syndromes. 95Mayo Clinic, Hematology Division, Rochester, MN, USA. Med Oncol. Bethesda, MD 20894, Web Policies Central Nervous System Tumours is the sixth volume in the 5th edition of the World Health Organization (WHO) series on the classification of human tumours. Leukemia. Joseph D. Khoury, Eric Solary or Andreas Hochhaus. Soft Tissue and Bone Tumours is the third volume in the 5th edition of the WHO series on the classification of human tumours. Blood. 2019;32:598608. The qualifying term childhood MDS emphasizes that this category of myeloid neoplasms is biologically distinct from that seen in adults [40, 41], underscoring the need to further elucidate its pathogenesis which remains incompletely understood. 2014;371:248898. A somatic point mutation in the KIT gene at codon 816 is detected in >90% of patients with SM. 2017;31:75962. For the rst time, certain tumour types are dened as much by their molecular Among histiocytic neoplasms, a subset of cases occurs in association with or follow a preceding lymphoma/leukaemia, most commonly follicular lymphoma, chronic lymphocytic leukaemia and T- or B-ALL [100]. Publication of the WHO Classification of Tumours , 5th Edition, Volume 73Section of Hematology/Oncology, Department of Medicine, Department of Human Genetics, The University of Chicago, Chicago, IL, USA. Montalban-Bravo G, Kanagal-Shamanna R, Guerra V, Ramos-Perez J, Hammond D, Shilpa P, et al. Extramedullary disease is common. Haematolymphoid Tumours. Schwaab J, Naumann N, Luebke J, Jawhar M, Somervaille TCP, Williams MS, et al. Egan C, Lack J, Skarshaug S, Pham TA, Abdullaev Z, Xi L, et al. The optimal cutoff for lymphoblasts and the significance of low-level B-lymphoblasts remain unclear and require additional studies. 2017;92:2926. 2021;21:e66e75. 110University of Cambridge & Wellcome Sanger Institute, Cambridge, United Kingdom. All listed authors edited and approved the manuscript. We thank the leadership and staff of the International Agency for Research on Cancer (IARC), Lyon, France, especially Dr. Ian Cree and Ms. Asiedua Asante, for their tireless efforts. 2006;81:48491. ALK+ histiocytosis: a novel type of systemic histiocytic proliferative disorder of early infancy. The 5th edition, guided by the WHO Classification of Tumours Editorial Board, will establish a single coherent cancer classification presented across a collection of individual volumes organized on the basis of anatomical site (digestive system, breast, soft tissue and bone, etc.) The integrated, layered diagnosis of combining histology, grading, and molecular information was recommended to provide clinically relevant information. Written by Christina Crowe. Major diagnostic criteria for the diagnosis of PV include elevated haemoglobin concentration and/or haematocrit, accompanied by trilineage hyperplasia (panmyelosis), with pleomorphic mature megakaryocytes in the bone marrow, and NM_004972:JAK2 p.V617F or JAK2 exon 12 mutations. Jaypee Gold Mini Standard Atlas Orthodontics PDF Free Download: Tara v shanbhag Pharmacology For Medical Graduates PDF Download:2023. National Library of Medicine 2018;150:42131. WHO Classification of Tumours: Urinary and Male Genital Tumours is now available in print format. 2021;106:30003. Some cytogenetic findings such as monosomy 7, 7q deletion, or complex karyotype are associated with an increased risk of progression to AML and typically treated with haematopoietic stem cell transplantation, while cases with normal karyotype or trisomy 8 can have an indolent course. Terminology of childhood MDS types is updated. 2012;61:107. IARC Publications Website - Thoracic Tumours 2021;27:180617. Blood. For the first time since the inception of the classification over 60 years ago, the current series (5th edition) has been developed within a unified relational database framework that encompasses the entirety of human cancers. Am J Clin Pathol. The term MDS/MPN with neutrophilia replaces the term atypical CML. This series (also known as the WHO Blue Books) is regarded as the gold standard for the diagnosis of tumours and comprises a unique synthesis of histopathological diagnosis with digital and . Nat Med. HHS Vulnerability Disclosure, Help This is envisioned as a landing spot in the classification to incorporate new/rare entities whose recognition is increasing as high-throughput molecular diagnostic tools become more available. The following colleagues are acknowledged for their expert contributions as authors in the WHO Classification of Haematolymphoid Tumours blue book on myeloid and histiocytic/dendritic cell topics: Lionel Ads53, Ivn Alvarez-Twose54, Lars Bullinger55, Andrey Bychkov56, Maria Calaminici57, Peter J Campbell58, Hlne Cav59, Kenneth Tou En Chang60, Jorge ECortes61, Immacolata Cozzolino62, Ian A Cree63, Sandeep S Dave64, Kara L Davis65, Rita De Vito66, Hans Joachim Deeg67, Elizabeth G. Demicco68, Ann-Kathrin Eisfeld69, Carlo Gambacorti-Passerini70, Francine Garnache Ottou71, Stephane Giraudier72, Lucy A Godley73, Peter L Greenberg74, Patricia T Greipp75, Alejandro Gru76, Sumeet Gujral77, Detlef Haase78, Claudia Haferlach27, Julien Haroche79, Xiao-Jun Huang80, Yin Pun Hung22, Ahmed Idbaih81, Masafumi Ito82, Thomas S Jacques83, Sidd Jaiswal38, Rhett P Ketterling84, Navin Khattry85, Rami S Komrokji41, Shinichi Makita86, Vikram Mathews87, L Jeffrey Medeiros1, Ruben Mesa88, Dragana Milojkovic6, Yasushi Miyazaki89, Valentina Nardi22, Gaurav Narula86, Seishi Ogawa90, Eduardo Olavarria91, Timothy S Olson92, Etan Orgel93, Sophie P Park94, Mrinal Patnaik95, Naveen Pemmaraju31, Mary-Elizabeth Percival68, Gordana Raca94, Jerald P Radich96, Sabrina Rossi97, Philippe Rousselot98, Felix Sahm99, David A Sallman41, Valentina Sangiorgio100, Marie Sebert101, Riccardo Soffietti102, Jamshid Sorouri Khorashad103, Karl Sotlar104, Karsten Spiekermann105, Papagudi Ganesan Subramanian106, Kengo Takeuchi107, Roberto Tirabosco108, Antonio Torrelo109, George S Vassiliou110, Huan-You Wang111, Bruce M Wenig112, David A Westerman113, David Wu114, Akihiko Yoshida115, Bernhard WH Zelger116, Maria Claudia Nogueira Zerbini117. To obtain (Table3) It is posited that such reorganization enhances classification rigor by emphasizing genetically-defined disease types and ceding the prior emphasis on risk-based grouping in the classification (based on blast percentage, ring sideroblasts, and number of lineages with dysplasia) in favour of more comprehensive risk-stratification schemes such as the Revised International Prognostic Scoring System for MDS (IPSS-R) [27]. In most patients with WDSM, KIT codon 816 mutationis not detected, and neoplastic mast cells are usually negative for CD25 and CD2 but positive for CD30 [26]. The last edition of the haematolymphoid classification dates back to 2008 and was revised in 2017. Fattizzo B, Ireland R, Dunlop A, Yallop D, Kassam S, Large J, et al. Overexpression of wild-type or mutants forms of CEBPA alter normal human hematopoiesis. It is hoped that the genetic underpinnings of the classification will prompt the provision of health resources to ensure that the necessary genetic testing platforms are available to peruse the full potential of the classification. 2021;34:33647. WHO CNS 5 also adopted a series of recommendations of "the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT)" that facilitates a consensus review of novel diagnostically relevant data and determines how such information can be fit into future CNS tumor classifications. 2017;18:10011. 80Peking University Peoples Hospital, Peking University Institute of Hematology, Peking University, Beijing, China. Thoracic Tumours is the fifth volume in the 5th edition of the World Health Organization (WHO) series on the classification of human tumours. AML defined by mutations include AML with NPM1 and AML with CEBPA mutation. 2020 Jun;25(6):997-1003. doi: 10.1007/s10147-020-01695-w. Epub 2020 May 28. 2021;193:9227. RUNX1 mutations in AML overlap with such a broad range of defining molecular features that it was determined to lack enough specificity to define a standalone AML type. A third component of the new structure is the introduction of a section on AML with other defined genetic alterations, a landing spot for new and/or uncommon AML subtypes that may (or may not) become defined types in future editions of the classification. 2011;24:142132. Wang SA, Hasserjian RP. In most circumstances, classification of a dendritic cell/macrophage neoplasm as Langerhans cell histiocytosis/sarcoma, indeterminate dendritic cell tumor, interdigitating dendritic cell sarcoma or histiocytic sarcoma is straightforward. Plasmacytoid dendritic cells proliferation associated with acute myeloid leukemia: phenotype profile and mutation landscape. The clinical manifestations of these diseases are grouped into three subtypes under which most germline predisposition conditions can be assigned. 2012;26:153746. Haematologica. PV and ET progress to AP (10-19% blasts) and BP (20% blasts) in a minority of cases, but leukaemic transformation is more frequent in PMF, and leukaemia-free survival is shorter in fibrotic than prefibrotic PMF [15, 16]. Allogenic haematopoietic stem cell transplantation is efficacious. Dutzmann CM, Spix C, Popp I, Kaiser M, Erdmann F, Erlacher M, et al. The latter supersedes MDS-5q and MDS-SF3B1. Cancer. Dominant clinical attributes are general features of the untreated disease and include descriptors such as acute, chronic, cytopenia(s) (myelodysplasia) and cytosis(es) (myeloproliferation). 71Inserm UMR1098, Universit de Franche-Comt, Laboratoire Hmatologie, Etablissement Franais du Sang Bourgogne Franche-Comt, Besanon, France. Alvarez-Twose I, Jara-Acevedo M, Morgado JM, Garcia-Montero A, Sanchez-Munoz L, Teodosio C, et al. The natural history of untreated CML before the introduction of targeted tyrosine kinase inhibitors (TKI) was biphasic or triphasic: an initial indolent CP followed by a blast phase (BP), with or without an intervening accelerated phase (AP). Accessibility High prevalence of myeloid neoplasms in adults with non-Langerhans cell histiocytosis. In addition, demonstration of a coordinated pattern of expression of multiple antigens from the same lineage further improves the specificity of those antigens for lineage assignment, e.g. Acute erythroid leukaemia (AEL) (previously pure erythroid leukaemia, an acceptable related term in this edition) is a distinct AML type characterized by neoplastic proliferation of erythroid cells with features of maturation arrest and high prevalence of biallelic TP53 alterations. Recognizing prefibrotic PMF remains necessary to separate it not only from ET and PV but also from fibrotic PMF [14]. 2015;373:3547. Clonal MPDCP cells accumulate in the bone marrow of patients with myeloproliferative CMML harbouring activating RAS pathway mutations [84]. Various groups have proposed flow cytometry thresholds for positive myeloperoxidase expression in acute leukaemia, ranging from 3 to 28% of blasts [81,82,83]. 2013;27:18703. 87Department of Hematology, Christian Medical College, Vellore, India. CMML post cytotoxic therapy. As the criteria of CEL and its place relative to other disorders with eosinophilia have become well characterized, the qualifier not otherwise specified is no longer needed and has been omitted from the name. McClain KL, Bigenwald C, Collin M, Haroche J, Marsh RA, Merad M, et al. Accordingly, a balanced approach was adopted by eliminating blast cutoffs for most AML types with defining genetic alterations but retaining a 20% blast cutoff to delineate MDS from AML. Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages. Valent P, Akin C, Gleixner KV, Sperr WR, Reiter A, Arock M, et al. Newly diagnosed isolated myeloid sarcoma-paired NGS panel analysis of extramedullary tumor and bone marrow. Leukemia. Emerging entities are listed as disease subtypes under a novel rubric of other defined genetic alterations. 67Clinical Research Division, Fred Hutchinson Cancer Center, Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, USA. Chan JK, Lamant L, Algar E, Delsol G, Tsang WY, Lee KC, et al. Diagnosis of myelodysplastic syndrome among a cohort of 119 patients with fanconi anemia: morphologic and cytogenetic characteristics. Hypoplastic MDS (MDS-h) is recognized as a distinct disease type. A blast count under 20% is acceptable based on studies demonstrating that patients with <20% blasts (MDS) and any of these rearrangements have clinical features that resemble those with higher blast counts. In some instances, defining genetic abnormalities of MLN-TK are acquired during course of a myeloid neoplasm such as MDS or MDS/MPN or at the time of MPN BP transformation. Diagnostic criteria of CEL are updated, and the qualifier NOS is omitted. Another key change, as indicated above, is the elimination of the 20% blast requirement for AML types with defining genetic abnormalities (with the exception of AML with BCR::ABL1 fusion and AML with CEBPA mutation). Open Access funding enabled and organized by Projekt DEAL. Nature. Notwithstanding, the full published classification will include listing of essential diagnostic criteria that have the broadest possible applicability, particularly in limited resource settings. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, Joseph D. Khoury,Shimin Hu,Rashmi Kanagal-Shamanna,Sanam Loghavi,Keyur P. 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