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The year 2022 was of particular importance for us as MLL. Many diagnostic innovations and guidelines for diagnostics, classification and prognosis are changing our laboratory workflow in many places - first and foremost the newly published WHO classification (5th Edition). The latest technology and artificial intelligence are also increasingly entering the routine. In this article, the MLL management looks back on an exciting year, highlights special highlights and thanks all our senders, partners and employees.

Every day, the MLL team works together to provide the best therapy for patients worldwide through rapid and targeted leukemia diagnostics. But what exactly does the day-to-day work of the more than 250 employees look like? Which departments and areas are there? Our magazine series "The MLL introduces itself" gives you an insight into our laboratory. In this part, we would like to introduce you to our Quality Management (QM) department.

We have been offering our submitting colleagues digital order entry for four years now. Of course, we want to make this as intuitive and user-friendly as possible for you. Therefore, based on your feedback, we have designed a new menu for quick requests, making order placement more time-efficient and intuitive. We are happy to introduce you to all the new features in the article below.

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.

Fusion transcripts and expression profiling are keywords that are important in the diagnosis of both B-ALL and MLN-TK. In the new WHO classification, the benefit but also the need of transcriptome analysis becomes clear for both entities. In both diagnostic approaches we use whole-transcriptome-sequencing and in B-ALL we use machine learning trained algorithms for classification based on expression profiles.

New diagnostic and prognostic recommendations (WHO, ELN, IPSS-M) place increased demands on the clinically active hematologist, but also increase the information content of diagnostic data. Of course, we have adapted our diagnostic offer and especially our molecular genetic standard panels accordingly. In addition, in order to support our submitting colleagues in the interpretation of findings, we have also taken into account the latest changes in diagnostic recommendations in our "Integrated Findings". You can read everything else in the article.

The 64th Annual Meeting & Exposition of the American Society of Hematology was held December 10-13 - this year locally in New Orleans. The MLL team was there with a total of 20 contributions. In this article, we would like to share with you the research projects that we had the pleasure of presenting at the ASH conference. Our contributions cover a wide range of hematology topics - from classification and genetics to prognostics and artificial intelligence.

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.

Chromosome analysis is an essential part of the diagnostics of malignant hematological diseases. It plays an important role in confirming the diagnostics, classification, prognosis assessment and therapy planning. The method is considered time-consuming and demanding, both laboratory-wise and in terms of evaluation and reporting. In addition to the continuous expansion of the automation of laboratory processes, the use of artificial intelligence (AI) in chromosome analysis in particular enables a significant reduction in the reporting time as well as a more objective and sensitive assessment of chromosomal changes.

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.

Those who know us know that we always look ahead, push boundaries, and rarely stand still. We have reviewed the last scientific year and summarized our research highlights in the new Research Report 2022. Feel free to get caught up in our own passion and immerse yourself in our research with us. In 2022, we were once again energized, curious, and enthusiastic about advancing the best possible leukemia diagnostics for our patients. 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.

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.

Wir laden Sie recht herzlich zu den Sobi Hämatologie Gesprächen ins MLL ein. Thematisch soll es um drei seltene Erkrankungen und deren Therapie gehen: das rezidivierte/refraktäre diffus großzellige B-Zell-Lymphom (r/r DLBCL), die chronische Immunthrombozytopenie (cITP) und die paroxysmale nächtliche Hämoglobinurie (PNH). Dabei möchten wir Ihnen die Möglichkeit geben, sich mit KollegInnen aus ganz Deutschland zu den aktuellen Therapie-Möglichkeiten auszutauschen und interessante Patientenfälle zu diskutieren. Alle weiteren Infos zum Programm und zur Anmeldungen finden Sie hier.

Das Würmtal-Labor und das MLL Münchner Leukämielabor veranstalten gemeinsam in Kooperation die Mikroskopierkurs-Reihe MADE (Mikroskopieren, Analysieren, Diskutieren, Einpacken). Insgesamt bieten wir 3 Kurse (MADE By Yourself, MADE für die Zukunft, Made @ home) zu unterschiedlichen Zeitpunkten an. Für alle Infos zum Programm sowie zur Anmeldung hier klicken.

The next MLL Academy will be held from April 24^th until April 28^th, 2023. During the five-day workshop on the subject of “state of the art diagnostics in hematological malignancies“, participants can expect a mix of theoretical and practical content as well as joint discussions, all concerning the diagnosis of leukemias and lymphomas. Please register until 15^th of February 2023.

Unsere Fortbildungsveranstaltung mit dem Thema "WHO, ICC, ELN/AML und IPSS-M: Die Bedeutung der Genetik für myeloische Entitäten von CCUS bis AML" ging am 16.11.2022 von 16.00 bis 18.00 Uhr in die zweite Runde: Im Fokus standen die Vielzahl an Neuerungen in den diagnostischen Guidelines. Die Veranstaltung fand virtuell statt, hier finden Sie alle Infos zum Programm sowie die Inhalte zur Nachschulung.

Termin verschoben auf Frühjahr 2023: Der Münchner Hämatologie-Diagnostik Kurs geht 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.