News

After the two preliminary publications on the new WHO classification (“The 5th edition of the World Health Organization Classification of Haematolymphoid Tumors”) were recently published in Leukemia (Khoury et al. Leukemia 2022, Alaggio et al. Leukemia 2022), the MLL Munich leukemia laboratory used this as an occasion to organize an advanced training event. There, in four expert lectures, the most important innovations in the classification were summarized and prepared for everyday diagnostic use. A follow-up report.

Five years have passed since the WHO classification of hematologic neoplasia was last updated. Since then, a great deal of knowledge has been gained – specifically in relation to genetic alterations. Each time the WHO classification is updated, purely morphological criteria recede more and more into the background, while genetic parameters have become increasingly relevant. MLL has been able to contribute its expertise to the new WHO classification. Recently, two publications appeared in advance, presenting the most important innovations in the classification of myeloid (Khoury et al. 2022) and lymphatic (Alaggio et al. 2022) neoplasia. We have briefly summarized the most important facts for you.

Every day, the MLL team focuses its combined efforts on making it possible for patients around the world to receive the best therapy thanks to quick and targeted leukemia diagnostics. But what exactly does the day-to-day work of the more than 200 employees look like? What departments and areas are there? Our magazine series, “MLL Introduces Itself”, provides you with an insight into our laboratory, with the fourth section introducing you to our HR Department.

Our goal is to continuously advance and develop leukemia diagnostics in order to make the best possible therapy available to patients worldwide. The exchange of information with (inter)national experts and partners, joint research projects, and the provision of all relevant data and latest findings play a significant role. To this end, we regularly host events at MLL – both virtual and on-site. In this article, we want to report on our latest events, including all highlights: the MLL Academy and the mid-term meeting of “INTERCEPT-MDS.”

Every day, the MLL team works together to provide patients worldwide with the best possible therapy through rapid and targeted leukemia diagnostics. But what exactly does the day-to-day work of the more than 200 employees look like? What departments and areas are there? Our magazine series, “MLL introduces itself”, provides you with an insight into our laboratory, with the third section introducing you to our secretariat.

Over the last two years we have worked hard on our brand architecture, developing it further, and making it fit for the future. During the course of this we have harmonized the layout of our websites and improved them by incorporating your feedback as a site user. The websites of MLL, MLL MVZ, and MLLSEQ are now available in a new and harmonized design. The goal was to increase the user-friendliness of the website and to allow for rapid and targeted navigation through its pages. We look forward to your visit and to your feedback!

Molecular genetics is entering the MDS prognosis. The IPSS-R is followed by the IPSS-M. The publication on this appeared in June of this year in the New England Journal of Medicine Evidence. We have summarized the data for you and explain where and how the IPSS-M is calculated.

Mature T-cell neoplasms represent a major diagnostic and therapeutic challenge in their clinical, histopathological and molecular heterogeneity. Currently, molecular genetic determination of the clonality of T-cell receptor rearrangements is recommended for diagnostic clarification. However, their detection alone is not sufficient to confirm T-cell neoplasia. To evaluate the potential utility of further genetic analysis in patients with suspicious T-cell populations, we performed next-generation sequencing (NGS) with a lymphoid gene panel in 83 patients. The results as well as the resulting extended diagnostic possibilities are presented in this article.

The standardization of BCR::ABL1 quantification according to the international scale (IS) is of great importance for managing chronic myeloid leukemia (CML). The laboratory-specific conversion factor required for this is redetermined annually during quality assurance rounds. Over the last five years, MLL has been a member of the EUTOS project, in which, among other things, a procedure was developed to allow each and every laboratory to determine its own conversion factor in the future. We have collected the most important results of the project for you plus its associated future innovations.

Clonal genetic changes in hematopoietic cells occur with increasing frequency with advancing age, even in individuals without hematological neoplasia. Due to the growing number of individuals aged ≥80 years in our society, the need arises to investigate the clinical relevance of such clonal hematopoiesis of indeterminate potential (CHIP). A recently published study by Rossi and colleagues (Blood 2021;138 (21): 2093–2105) examined blood samples from 1794 individuals aged ≥80 years who have not been diagnosed with hematological neoplasia for mutations in 47 genes implicated in myeloid neoplasia

The 63rd Annual Meeting & Exposition of the American Society of Hematology was held on December 11-14 – this year as a hybrid event for the first time. The MLL team attended virtually with a total of 13 contributions. The main topics were the continuous improvement of today’s gold standard and the diagnostics of tomorrow, including the use of artificial intelligence (AI) in the clinical routine and research, along with genome-wide methods of WGS (whole genome sequencing) and WTS (whole transcriptome sequencing). We have summarized for you all of this year’s ASH presentations with MLL participation.

Various research projects have shown that new technologies such as whole genome sequencing (WGS) and whole transcriptome sequencing (WTS) provide added value for patients with acute leukemia. In the coming year, the MLL will be offering both diagnostics using classical methods as well as WGS/WTS analysis for acute leukemia. We want to pass this added clinical value on to our patients while at the same time learning from the knowledge gained. We also want to put WGS/WTS to the test in order to validate their clinical benefit.

We take artificial intelligence (AI) for granted these days and often use it in our everyday lives without noticing. But what does this mean for diagnostics – today and in the future? At MLL, artificial intelligence is used in various areas of diagnostics and is constantly being further developed. This not only saves time but will also facilitate the training of new staff in the future and expand opportunities for global collaboration. The aim is to provide patients with easier access to precise and rapid diagnoses and thus access to the best possible therapy.

The Munich Leukemia Laboratory and the newly founded Institute of AI for Health (AIH) of the Helmholtz Center of Munich have agreed on comprehensive collaboration for research and development. The primary goal is the implementation of machine learning and artificial intelligence in various areas of leukemia diagnostics.

Even before the start of the COVID-19 pandemic, we saw how strongly digitalization is shaping our private and professional lives and will continue to do so in the future. This also applies to innovations for daily work in the paperless Munich Leukemia Laboratory (MLL), such as the complete digitalization of all medical findings in a constantly improving digital infrastructure. However, AI will mark a new era for medical diagnostic services as well.

Whether a search engine or digital assistant is involved, artificial intelligence (AI) has long been a part of our day-to-day work. There are success stories in imaging-based diagnostics thanks to AI as well. Preliminary studies, for example, indicate that the classification of medical findings using AI is equivalent to traditional methods.

Making a patient disease diagnosis on the basis of Next-Generation Sequencing (NGS) data is a complex endeavor. To be able to make an exact diagnosis, medical professionals must be able to access all the available information pertaining to the specific genetic variants detected.

In AML and ALL the application of WHO classification and ELN guidelines requires a plethora of methods to determine the diagnostic and prognostic subgroup. Especially in ALL, many different subtypes have been described, which makes accurate diagnosis a challenge. However, in recent years, whole genome and whole transcriptome sequencing have emerged as comprehensive high-throughput techniques that allow for an accurate genetic characterization. This identification of patients’ genetic fingerprint is key to a precise diagnosis and the design of personalised cancer treatments.

Even though the last two years have been dominated by the pandemic, we have kept science firmly in our mind. Providing the best possible care for our oncology patients remains our heartfelt mission. After another scientifically successful year, we would like to take the opportunity to summarize our findings of 2021. To further facilitate reading and to better convey our data, we have included various graphical representations and summaries and we hope you enjoy the content.

Visualization of genomic and transcriptomic data is essential to easily exploring those large datasets for interpretation and hypothesis generation and can further help to uncover hidden patterns and trends. With the ongoing development of sequencing and computer technologies, it has become feasible for scientists and clinicians to reliably collect large amounts of high-quality sequence information from DNA and RNA molecules. The analysis and interpretation of such datasets are now routine aspects of many research projects in biology and medicine, creating a need for new tools and methods to also visualize the data and the findings.

With the decrease of sequencing costs, the number of freely available "omics" data sets also increases, opening a nearly unlimited quantity of molecular genetic information. For the last decades the classical way of elucidating multifaceted molecular networks of diseases has been to break down the system into smaller, more traceable parts.

For nearly half a century acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) have been separated according to the percentage of bone marrow blasts. However, the last ten years have shown that the incorporation of genetic information in the classification improves its accuracy in diagnosis and prognosis.

The project was started in 2017 with the aim to sequence the genome and transcriptome of 5,000 patients with haematological malignancies, in order to obtain a more in-depth knowledge of their molecular profiles to better understand the underlying complexity, to refine diagnosis, and also to take another step in the direction of personalized medicine.

Unsere Fortbildungsveranstaltung in hybridem Format geht in die zweite Runde: Aufgrund einer Vielzahl an Neuerungen in den diagnostischen Guidelines laden wir Sie am 16. November 2022 von 16.00 - 18.00 Uhr zur Veranstaltung „WHO, ICC, ELN/AML und IPSS-M: Die Bedeutung der Genetik für myeloische Entitäten von CCUS bis AML“ ein. Die Veranstaltung findet live vor Ort bei uns im MLL statt, alternativ ist auch eine virtuelle Teilnahme möglich. Weitere Infos zum Programm und zur Anmeldung folgen zeitnah.

Am 22. Oktober 2022 von 8.30 - 13 Uhr geht der Münchner Hämatologie-Diagnostik Kurs in seine dritte Runde. Gemeinsam organisiert von der Ludwig-Maximilians-Universität München (LMU), der Technischen Universtität München (TUM) und dem MLL Münchner Leukämielabor, dürfen sich die TeilnehmerInnen auf einen gemeinsamen hämatologischen Diagnostik-Kurs mit Schwerpunkt Morphologie/FACS freuen. Die Veranstaltung findet sowohl live vor Ort im MLL als auch virtuell statt. Für alle Infos hier klicken.

Am Freitag, den 21. Oktober 2022 (9.00 - 17.30 Uhr) findet das Onkologische Symposium 2022 statt. Die Symposiumsreihe „Vom Biomarker zur Therapie" bietet einen Einblick in die moderne onkologische Präzisionsmedizin, die innovative Diagnoseverfahren und Therapiestrategien zu einem großen Ganzen verbindet. An der Veranstaltung kann vor Ort im MLL Münchner Leukämielabor (begrenzte Teilnehmerzahl) oder aber im virtuellen Livestream teilgenommen werden. Hier geht's zum Programm und zur Anmeldung.