cap/ash guidelines for initial work-up for acute leukemia

210 Pages·2016·58.35 MB·English

CAP/ASH GUIDELINES FOR INITIAL
WORK-UP FOR ACUTE LEUKEMIA

Karl S Theil MD
Robert P Hasserjian MD
SPEAKER
 DISCLOSURE

In
 the
 past
 12
 months,
 we
 have
 not
 had
 a

significant
 financial
 interest
 or
 other
 rela8onship

with
 the
 manufacturer(s)
 of
 the
 product(s)
 or

provider(s)
 of
 the
 service(s)
 that
 will
 be

discussed
 in
 this
 presenta8on.
Objec2ves

•  Review
 development
 process
 for
 this
 prac8ce

guideline

•  Determine
 proper
 sample
 collec8on
 at
 the

8me
 of
 diagnosis

•  Iden8fy
 key
 decision
 points
 that
 trigger

appropriate
 test
 ordering

•  Apply
 CAP/ASH
 recommenda8ons
 for
 test

selec8on
Agenda

•  Introduc8on
 to
 the
 Guidelines

•  Overview
 of
 WHO
 AML
 and
 ALL
 Classifica8on

•  Prac8cal
 Considera8ons
 in
 AL
 Diagnosis

•  Diagnos8c
 Criteria
 and
 Differen8al
 Diagnosis

•  Immunophenotypic
 Dis8nc8on
 of
 AML
 and
 ALL

•  Case
 Studies:
 Applica8on
 of
 the
 Guideline

•  Summary
 and
 Closing

Dra$
 Guideline
 Statements
 are
 provided
 in
 handout
Why
 Have
 Guidelines?

Guidelines
 have
 the
 poten5al
 to:

•  Standardize
 care
 across
 all
 seQngs

•  Reduce
 duplica8on
 of
 tes8ng

•  Support
 the
 use
 of
 specific
 tests

•  Improve
 pa8ent
 care
 and
 outcomes
A
 Complex
 System

The
 diagnosis
 and
 prognos8c
 assessment

of
 acute
 leukemia
 currently
 incorporates:

•  Clinical
 informa8on

•  Morphology

•  Immunophenotyping

•  Cytogene8cs

•  Molecular
 gene8cs
The
 CAP/ASH
 Guidelines

for
 Acute
 Leukemia

•  The
 CAP
 Center
 develops
 evidence-­‐based

guidelines
 (EBGs)
 and
 consensus
 statements

related
 to
 the
 prac8ce
 of
 pathology
 and

laboratory
 medicine.

•  These
 guidelines
 are
 used
 to
 improve

diagnos8c
 procedures
 and
 tes8ng
 that
 will

allow
 for
 more
 informed
 pa8ent

management
 and
 improved
 pa8ent

outcomes.
Guideline
 Panel
 Members

Expert
 Panel
  Advisory
 Panel

Daniel
 Arber,
 MD,
 Co-­‐Chair,
 CAP
  Frederick
 Appelbaum,
 MD

James
 Vardiman,
 MD,
 Co-­‐Chair,
 ASH
  Clara
 Bloomfield,
 MD

Michael
 Borowitz,
 MD,
 PhD,
 ASH
  William
 L.
 Carroll,
 MD

Melissa
 Cessna,
 MD,
 CAP
  Laura
 Housley
 (Pa8ent
 Advocate)

Joan
 Etzell,
 MD,
 CAP
  Jerry
 Hussong,
 MD

Kathryn
 Foucar,
 MD,
 ASH
  Steven
 H.
 KroZ,
 MD,
 FASCP

Robert
 Hasserjian,
 MD,
 ASH
  Michelle
 Le
 Beau,
 PhD

J.
 Douglas
 Rizzo,
 MD,
 ASH
  Mar8n
 S.
 Tallman,
 MD

Karl
 Theil,
 MD,
 CAP

Sa
 Wang,
 MD,
 CAP
Staff
 from
 CAP
 and
 ASH

Nicole
 Thomas,
 MPH,
 CT(ASCP),
 CAP

Robert
 Plovnick,
 MD,
 ASH

Robert
 Kunkle,
 ASH

Kendall
 Alexander,
 MPH,
 ASH

R.
 Bryan
 Rumble,
 MSc
 (Contracted
 Methodologist)

Chris8na
 LaccheQ,
 MHSc
 (Contracted

Methodologist)

Tony
 Smith,
 MLS,
 CAP
 (Medical
 Librarian)
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