Leukemia & Lymphoma classification at PMGH: what do we do when we can’t reach global standards?

I failed my specialist training in 2016 and decided to take a year off in 2017 to write and publish some of my work in medical journals. My interest is in Pathology, the science of studying diseases and I have a special interest in hematopathology, a subspecialty that concentrate in diseases of the blood (leukemia and lymphoma).

Supported by my supervisors at PMGH I was fortunate to secure a training fellowship for 8 weeks at Maryland Medical Center, Baltimore, USA. I have been here for 5 weeks and got 3 more weeks before I return. I am supported by the American Society for Hematopathology (ASH).

All leukemias and lymphomas are classified after diagnosis. The classification systems have changed over the years, the current global system is the WHO system. But PMGH is still using outdated classification systems which are regarded in most settings to be obsolete. But we have no choice really! We can not classify these diseases without doing very specialized testing​, which I might add are very expensive. So where does that leave us?

WHO system of classification of blood cancers it seems assumes that all hospitals providing Hematopathology services have these tests or plan to have these tests. But the reality is far from the truth.

So that leaves PMGH to continue with using outdated systems? I guess we must. This is probably the same situation in most low to middle income counties.

So what do we do? I think we should strive to reach the standards​ set before us. We might not get there in 5 or 10 or maybe 20 years. We may not even reach there in my lifetime. But we must make a start.



About rodney itaki

Medical doctor and public health specialist from Papua New Guinea.
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