The fifth edition of the WHO classification of mature B-cell neoplasms: open questions for research

Sarah E. Coupland, Ming-Qing du, Judith A. Ferry, Daphne de Jong, Joseph D. Khoury, Lorenzo Leoncini, Kikkeri N. Naresh, German Ott, Reiner Siebert, Luc Xerri

Research output: Contribution to journalReview articleAcademicpeer-review

4 Citations (Scopus)

Abstract

The fifth edition of the World Health Organization Classification of Haematolymphoid Tumours (WHO-HAEM5) is the product of an evidence-based evolution of the revised fourth edition with wide multidisciplinary consultation. Nonetheless, while every classification incorporates scientific advances and aims to improve upon the prior version, medical knowledge remains incomplete and individual neoplasms may not be easily subclassified in a given scheme. Thus, optimal classification requires ongoing study, and there are certain aspects of some entities and subtypes that require further refinements. In this review, we highlight a selection of these challenging areas to prompt more research investigations. These include (1) a ‘placeholder term’ of splenic B-cell lymphoma/leukaemia with prominent nucleoli (SBLPN) to accommodate many of the splenic lymphomas previously classified as hairy cell leukaemia variant and B-prolymphocytic leukaemia, a clear new start to define their pathobiology; (2) how best to classify BCL2 rearrangement negative follicular lymphoma including those with BCL6 rearrangement, integrating the emerging new knowledge on various germinal centre B-cell subsets; (3) what is the spectrum of non-IG gene partners of MYC translocation in diffuse large B-cell lymphoma/high-grade B-cell lymphoma and how they impact MYC expression and clinical outcome; how best to investigate this in a routine clinical setting; and (4) how best to define high-grade B-cell lymphoma not otherwise specified and high-grade B-cell lymphoma with 11q aberrations to distinguish them from their mimics and characterise their molecular pathogenetic mechanism. Addressing these questions would provide more robust evidence to better define these entities/subtypes, improve their diagnosis and/or prognostic stratification, leading to better patient care.

Original languageEnglish
Pages (from-to)255-270
Number of pages16
JournalJournal of pathology
Volume262
Issue number3
DOIs
Publication statusPublished - 1 Mar 2024

Keywords

  • World Health Organization Classification of Haematolymphoid Tumours (WHO-HAEM5)
  • classification
  • diagnosis
  • mature B-cell lymphoma

Cite this