InterLymph hierarchical classification of lymphoid neoplasms for epidemiologic research based on the WHO classification (2008): update and future directions
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After publication of the updated World Health Organization (WHO) classification of tumors of hematopoietic and lymphoid tissues in 2008, the Pathology Working Group of the International Lymphoma Epidemiology Consortium (InterLymph) now presents an update of the hierarchical classification of lymphoid neoplasms for epidemiologic research based on the 2001 WHO classification, which we published in 2007. The updated hierarchical classification incorporates all of the major and provisional entities in the 2008 WHO classification, including newly defined entities based on age, site, certain infections, and molecular characteristics, as well as borderline categories, early and “in situ” lesions, disorders with limited capacity for clinical progression, lesions without current International Classification of Diseases for Oncology, 3rd Edition codes, and immunodeficiency-associated lymphoproliferative disorders. WHO subtypes are defined in hierarchical groupings, with newly defined groups for small B-cell lymphomas with plasmacytic differentiation and for primary cutaneous T-cell lymphomas. We suggest approaches for applying the hierarchical classification in various epidemiologic settings, including strategies for dealing with multiple coexisting lymphoma subtypes in one patient, and cases with incomplete pathologic information. The pathology materials useful for state-of-the-art epidemiology studies are also discussed. We encourage epidemiologists to adopt the updated InterLymph hierarchical classification, which incorporates the most recent WHO entities while demonstrating their relationship to older classifications.
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North American registries use SEER multiple-primary rules, which count more cancers as new primaries than the IACR rules used in most other continents.
“North American registries define multiple primary cancers under the rules of the Surveillance Epidemiology and End Results (SEER) programme.22 Those rules accept more cancers as new primary cancers than the rules of the International Association of Cancer Registries (IACR),23 which are used by most cancer registries in other continents.”
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Self-citation
- Authors
- Turner, J. J., Morton, L. M., Linet, M. S., Clarke, C. A., Kadin, M. E., Vajdic, C. M., Monnereau, A., Maynadié, M., Chiu, B. C.-H., Marcos-Gragera, R., Costantini, A. S., Cerhan, J. R., & Weisenburger, D. D.
- Affiliations
- Douglass Hanly Moir Pathology (AU)
- National Institutes of Health (US)
- Cancer Prevention Institute of California (US)
- Boston University (US)
- UNSW Sydney (AU)
- Inserm (FR)
- Université de Bourgogne (FR)
- University of Chicago (US)
- Epidemiology Unit, Cancer Registry of Girona, Oncology Planning, Department of Health, Institute of Biomedical Investigation, Girona, Spain;
- Cancer Research and Prevention Institute Epidemiology, Florence, Italy;
- Mayo Clinic (US)
- University of Nebraska Medical Center (US)
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2010-11-18
- Volume
- 116
- Issue
- 20
- Pages
- e90-e98
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC2993636
- OpenAlex
- W2070728536
- Cited by
- 231
- References
- 45
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 5 · 2023: 9 · 2022: 10 · 2021: 8 · 2020: 19 · 2019: 11 · 2018: 15 · 2017: 7 · 2016: 18 · 2015: 25 · 2014: 39 · 2013: 25 · 2012: 16
- FWCI
- 10.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health (CA97274)
- National Cancer Institute (CA97274, R01 CA97274, R01CA092153, P50CA097274)
- National Center for Research Resources (P20RR018757)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
- Health Sciences › Medicine › Emergency Medicine › Hematological disorders and diagnostics
- Keywords
- lymphoid malignancies, hierarchical classification, lymphoma epidemiology, lymphoma subtypes, primary cutaneous T-cell lymphoma
- MeSH terms
- Humans, Lymphoma, Societies, Medical, World Health Organization, Epidemiologic Studies
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