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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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Submitted November 2, 2006
Accepted March 10, 2007
Proposed classification of lymphoid neoplasms for epidemiologic research from the International Lymphoma Epidemiology Consortium (InterLymph)
Lindsay M Morton*, Jennifer J Turner, James R Cerhan, Martha S Linet, Patrick A Treseler, Christina A Clarke, Andrew Jack, Wendy Cozen, Marc Maynadie, John J Spinelli, Adele Seniori Costantini, Thomas Rudiger, Aldo Scarpa, Tongzhang Zheng, and Dennis D Weisenburger
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, United States
Department of Anatomical Pathology, St. Vincent's Hospital, New South Wales, Australia
Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, United States
Department of Pathology, University of California at San Francisco, San Francisco, CA, United States
Northern California Cancer Center, Fremont, CA, United States
Haematological Malignancy Diagnostic Service, Department of Haematology, Leeds Teaching Hospital, NHS Trust, Leeds, United Kingdom
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
Haematology Laboratory, University Hospital, Dijon, France
British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Occupational and Environmental Epidemiology Unit, Center for Study and Prevention of Cancer, Scientific Institute of Tuscany, Florence, Italy
Institute of Pathology, University of Wurzburg, Wurzburg, Germany
Department of Pathology, University of Verona, Ospedale Policlinico, Verona, Italy
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, United States
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
* Corresponding author; email: mortonli{at}mail.nih.gov.
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 pathological 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 Diseases-Oncology, 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 likely prove to be critical for elucidating etiologies of the various lymphoid neoplasms.
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