Proposed terminology for post-AML CH states
| Term . | Definition and significance . |
|---|---|
| gMRD | AML-related genetic abnormality detectable after treatment (Figure 1A) |
| CH | Non-AML–related somatic genetic abnormality detectable after treatment, which may or may not have been detectable in the original diagnostic AML sample (Figure 1B-C) |
| Donor-derived CHIP | CH shown to be of donor hematopoietic cell origin, detected after HCT for AML (Figure 1I) |
| RMN | Morphologic and clinical evidence of MDS, MPN, or MDS/MPN in CR, supported by genetic evidence of clonality (CH) sharing any somatic genetic abnormalities with the antecedent AML (Figure 1D) |
| New myeloid neoplasm clonally unrelated to AML | MDS, MPN, or MDS/MPN with genetic features that are entirely different from the antecedent AML; if MDS or MDS/MPN, considered to be a therapy-related myeloid neoplasm |
| Donor-derived myeloid neoplasm | MDS, MPN, or MDS/MPN shown to be of donor hematopoietic cell origin, developing after HCT for AML |
| Germline mutation | Germline (nonsomatic) mutation, present in both pre- and posttherapy time points; should specify if donor-derived in the post-HCT setting (Figure 1E) |
| Recurrent/relapsed AML | ≥5% blasts in BM after CR with at least 1 AML-related and/or CH somatic genetic abnormality shared with the original AML (Figure 1F-G) |
| New clonally unrelated AML | ≥20% myeloid blasts* in blood or BM after CR lacking any shared somatic genetic aberrations with the original AML; considered to represent a therapy-related AML (Figure 1H) |
| Donor-derived AML | ≥20% myeloid blasts* in blood or BM shown to be of donor hematopoietic cell origin, developing after HCT for AML |
| Term . | Definition and significance . |
|---|---|
| gMRD | AML-related genetic abnormality detectable after treatment (Figure 1A) |
| CH | Non-AML–related somatic genetic abnormality detectable after treatment, which may or may not have been detectable in the original diagnostic AML sample (Figure 1B-C) |
| Donor-derived CHIP | CH shown to be of donor hematopoietic cell origin, detected after HCT for AML (Figure 1I) |
| RMN | Morphologic and clinical evidence of MDS, MPN, or MDS/MPN in CR, supported by genetic evidence of clonality (CH) sharing any somatic genetic abnormalities with the antecedent AML (Figure 1D) |
| New myeloid neoplasm clonally unrelated to AML | MDS, MPN, or MDS/MPN with genetic features that are entirely different from the antecedent AML; if MDS or MDS/MPN, considered to be a therapy-related myeloid neoplasm |
| Donor-derived myeloid neoplasm | MDS, MPN, or MDS/MPN shown to be of donor hematopoietic cell origin, developing after HCT for AML |
| Germline mutation | Germline (nonsomatic) mutation, present in both pre- and posttherapy time points; should specify if donor-derived in the post-HCT setting (Figure 1E) |
| Recurrent/relapsed AML | ≥5% blasts in BM after CR with at least 1 AML-related and/or CH somatic genetic abnormality shared with the original AML (Figure 1F-G) |
| New clonally unrelated AML | ≥20% myeloid blasts* in blood or BM after CR lacking any shared somatic genetic aberrations with the original AML; considered to represent a therapy-related AML (Figure 1H) |
| Donor-derived AML | ≥20% myeloid blasts* in blood or BM shown to be of donor hematopoietic cell origin, developing after HCT for AML |
The 20% blast threshold is applied for a genetically unrelated AML because this is a new disease and thus should fulfill criteria to establish a primary diagnosis of AML.