Hematology-Oncology

Hematology-Oncology

The diagnostic approach in Hematology-Oncology (the study of hematologic neoplasms) should be based on the World Health Organization’s (WHO 2008, revised in 2016) classification of tumors of the hematopoietic and lymphoid tissues, which is based on morphological, immunophenotypic, genetic, and clinical data.

The diagnosis and prognostic assessment of hematologic neoplasms, being a multidisciplinary process, require close collaboration between clinical departments and the laboratory. This ensures the rational use of available resources while still performing the tests deemed necessary for the intended purposes, which often involve the use of samples obtained through invasive procedures.

The main hematologic neoplasms are:

• Myeloproliferative neoplasms (BCR-ABL1+ chronic myeloid leukemia, chronic neutrophilic leukemia, polycythemia vera, primary myelofibrosis, essential thrombocythemia, chronic eosinophilic leukemia, and unclassifiable myeloproliferative neoplasm).
• Myeloid/lymphoid neoplasms with eosinophilia and abnormalities in the PDGFRA, PDGFRB, FGFR1, or PCM1-JAK2 genes.
• Myelodysplastic/myeloproliferative neoplasms (chronic myelomonocytic leukemia, atypical BCR-ABL1+ chronic myeloid leukemia-, juvenile myelomonocytic leukemia, myelodysplastic/myeloproliferative neoplasm with ringed sideroblasts and thrombocytosis, and unclassifiable myelodysplastic/myeloproliferative neoplasm).
• Myelodysplastic syndromes (MDS with unilineage dysplasia, MDS with ring sideroblasts and unilineage dysplasia, MDS with ring sideroblasts and multilineage dysplasia, MDS with multilineage dysplasia, MDS with blast excess, MDS with isolated del(5q), unclassifiable MDS, and refractory cytopenia of childhood).
• Acute myeloid leukemia and related neoplasms.
• Plasmacytoid dendritic blast cell neoplasms.
• Acute leukemias of ambiguous lineage.
• Lymphoblastic leukemia/lymphoma (B- or T-cell).
• NK-cell lymphoblastic leukemia/lymphoma.
• Mature B-cell lymphoid neoplasms [chronic lymphocytic leukemia/lymphocytic lymphoma, monoclonal B-cell lymphocytosis, B-cell prolymphocytic leukemia, splenic marginal zone lymphoma, tricholeukemia, unclassifiable splenic B-cell lymphoma/leukemia, lymphoplasmacytic lymphoma, monoclonal IgM gammopathy of undetermined significance (IgM MGUS), monoclonal IgG/A gammopathy of undetermined significance (IgG/A MGUS), plasmacytoma (multiple myeloma), MALT lymphoma, nodal marginal zone lymphoma, follicular lymphoma, mantle cell lymphoma, diffuse large B-cell lymphoma, plasmablastic lymphoma, Burkitt lymphoma, etc.].
• Mature T- and NK-cell lymphoid neoplasms (T-cell prolymphocytic leukemia, large granular T-cell leukemia, chronic NK-cell lymphoproliferative disease, aggressive NK-cell leukemia, adult T-cell leukemia/lymphoma, Sézary syndrome, anaplastic large-cell lymphoma, etc.).
• Hodgkin lymphoma.
• Post-transplant lymphoproliferative disorders.
• Histiocytic and dendritic cell neoplasms.