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Blood, 15 July 2007, Vol. 110, No. 2, pp. 695-708.
Prepublished online as a Blood First Edition Paper on March 27, 2007; DOI 10.1182/blood-2006-11-051672.
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NEOPLASIA
Proposed classification of lymphoid neoplasms for epidemiologic research from the Pathology Working Group of the International Lymphoma Epidemiology Consortium (InterLymph)
Lindsay M. Morton1,
Jennifer J. Turner2,
James R. Cerhan3,
Martha S. Linet1,
Patrick A. Treseler4,
Christina A. Clarke5,
Andrew Jack6,
Wendy Cozen7,
Marc Maynadié8,
John J. Spinelli9,
Adele Seniori Costantini10,
Thomas Rüdiger11,
Aldo Scarpa12,
Tongzhang Zheng13, and
Dennis D. Weisenburger14
1 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD;
2 Department of Anatomical Pathology, St Vincent's Hospital, New South Wales, Australia;
3 Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN;
4 Department of Pathology, University of California at San Francisco, CA;
5 Northern California Cancer Center, Fremont;
6 Haematological Malignancy Diagnostic Service, Department of Haematology, Leeds Teaching Hospital, National Health Service (NHS) Trust, Leeds, United Kingdom;
7 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles;
8 Haematology Laboratory, University Hospital, Dijon, France;
9 British Columbia Cancer Agency, Vancouver, BC, Canada;
10 Occupational and Environmental Epidemiology Unit, Center for Study and Prevention of Cancer, Scientific Institute of Tuscany, Florence, Italy;
11 Institute of Pathology, University of Wurzburg, Germany;
12 Department of Pathology, University of Verona, Ospedale Policlinico, Verona, Italy;
13 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT; and
14 Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha
Recent evidence suggests that there is etiologic heterogeneity among the various subtypes of lymphoid neoplasms. However, epidemiologic analyses by disease subtype have proven challenging due to the numerous clinical and pathologic schemes used to classify lymphomas and lymphoid leukemias over the last several decades. On behalf of the International Lymphoma Epidemiology Consortium (InterLymph) Pathology Working Group, we present a proposed nested classification of lymphoid neoplasms to facilitate the analysis of lymphoid neoplasm subtypes in epidemiologic research. The proposed classification is based on the World Health Organization classification of lymphoid neoplasms and the International Classification of DiseasesOncology, Third Edition (ICD-O-3). We also provide a translation into the proposed classification from previous classifications, including the Working Formulation, Revised European-American Lymphoma (REAL) classification, and ICD-O-2. We recommend that epidemiologic studies include analyses by lymphoma subtype to the most detailed extent allowable by sample size. The standardization of groupings for epidemiologic research of lymphoma subtypes is essential for comparing subtype-specific reports in the literature, harmonizing cases within a single study diagnosed using different systems, as well as combining data from multiple studies for the purpose of pooled analysis or meta-analysis, and will probably prove to be critical for elucidating etiologies of the various lymphoid neoplasms.

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