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World Health Organization-defined classification of myeloproliferative neoplasms: Morphological reproducibility and clinical correlations-The Danish experience

Madelung, Ann Brinch ; Bondo, Henrik ; Stamp, Inger ; Loevgreen, Preben ; Nielsen, Signe Ledou ; Falensteen, Anne ; Knudsen, Helle ; Ehinger, Mats LU ; Dahl-Sorensen, Rasmus and Mortensen, Nana Brochmann , et al. (2013) In American Journal of Hematology 88(12). p.1012-1016
Abstract
We examined inter-and intraobserver reproducibility and concordance between histological diagnosis and independently collected clinical findings in a large series of patients with the major subtypes of myeloproliferative neoplasms (MPNs) and controls. Seven hematopathologists reviewed 272 bone marrow biopsies including 43 controls. Diagnoses were determined according to the 2008 criteria of the World Health Organization (WHO). The participants were blinded to all clinical data except patient age. After initial evaluation all hematopathologists participated in a 3-day meeting with a leading clinician chaired by an expert hematopathologists. In cases with lack of consensus on fiber grading (n=57), a new evaluation was performed. In cases... (More)
We examined inter-and intraobserver reproducibility and concordance between histological diagnosis and independently collected clinical findings in a large series of patients with the major subtypes of myeloproliferative neoplasms (MPNs) and controls. Seven hematopathologists reviewed 272 bone marrow biopsies including 43 controls. Diagnoses were determined according to the 2008 criteria of the World Health Organization (WHO). The participants were blinded to all clinical data except patient age. After initial evaluation all hematopathologists participated in a 3-day meeting with a leading clinician chaired by an expert hematopathologists. In cases with lack of consensus on fiber grading (n=57), a new evaluation was performed. In cases with discordance on morphological diagnosis (n=129), an additional nonblinded evaluation taking clinical data into consideration was carried out. For remaining cases with a lack of concordance between morphological diagnosis and clinical diagnosis (n=33), a similar nonblinded evaluation was performed. Consensus on final histological diagnosis and concordance with clinical diagnosis were determined. Blinded histological evaluation resulted in a 53% consensus rate. After re-evaluation of fiber content, consensus was reached in 60% of cases. Adding clinical data increased the histological consensus to 83%. For cases with a histological consensus, we found a concordance of 71% with the clinician's diagnoses. This is the first study to present a larger cohort of MPN patients mimicking the diagnostic challenges that hematopathologists face in their daily practice. The results support the postulates of the WHO that both morphological and clinical findings are essential for a valid diagnosis Am. J. Hematol. 88: 1012-1016, 2013. (C) 2013 Wiley Periodicals, Inc. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Hematology
volume
88
issue
12
pages
1012 - 1016
publisher
John Wiley and Sons Inc.
external identifiers
  • wos:000327224000127
  • scopus:84888053932
  • pmid:23897670
ISSN
0361-8609
DOI
10.1002/ajh.23554
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pathology, (Lund) (013030000)
id
e1388052-ecc4-4383-86b1-313bf2cbee48 (old id 4272692)
date added to LUP
2016-04-01 10:35:10
date last changed
2020-10-04 03:40:57
@article{e1388052-ecc4-4383-86b1-313bf2cbee48,
  abstract     = {We examined inter-and intraobserver reproducibility and concordance between histological diagnosis and independently collected clinical findings in a large series of patients with the major subtypes of myeloproliferative neoplasms (MPNs) and controls. Seven hematopathologists reviewed 272 bone marrow biopsies including 43 controls. Diagnoses were determined according to the 2008 criteria of the World Health Organization (WHO). The participants were blinded to all clinical data except patient age. After initial evaluation all hematopathologists participated in a 3-day meeting with a leading clinician chaired by an expert hematopathologists. In cases with lack of consensus on fiber grading (n=57), a new evaluation was performed. In cases with discordance on morphological diagnosis (n=129), an additional nonblinded evaluation taking clinical data into consideration was carried out. For remaining cases with a lack of concordance between morphological diagnosis and clinical diagnosis (n=33), a similar nonblinded evaluation was performed. Consensus on final histological diagnosis and concordance with clinical diagnosis were determined. Blinded histological evaluation resulted in a 53% consensus rate. After re-evaluation of fiber content, consensus was reached in 60% of cases. Adding clinical data increased the histological consensus to 83%. For cases with a histological consensus, we found a concordance of 71% with the clinician's diagnoses. This is the first study to present a larger cohort of MPN patients mimicking the diagnostic challenges that hematopathologists face in their daily practice. The results support the postulates of the WHO that both morphological and clinical findings are essential for a valid diagnosis Am. J. Hematol. 88: 1012-1016, 2013. (C) 2013 Wiley Periodicals, Inc.},
  author       = {Madelung, Ann Brinch and Bondo, Henrik and Stamp, Inger and Loevgreen, Preben and Nielsen, Signe Ledou and Falensteen, Anne and Knudsen, Helle and Ehinger, Mats and Dahl-Sorensen, Rasmus and Mortensen, Nana Brochmann and Svendsen, Kira Dynnes and Lange, Theis and Ralfkiaer, Elisabeth and Nielsen, Karsten and Hasselbalch, Hans Carl and Thiele, Juergen},
  issn         = {0361-8609},
  language     = {eng},
  number       = {12},
  pages        = {1012--1016},
  publisher    = {John Wiley and Sons Inc.},
  series       = {American Journal of Hematology},
  title        = {World Health Organization-defined classification of myeloproliferative neoplasms: Morphological reproducibility and clinical correlations-The Danish experience},
  url          = {http://dx.doi.org/10.1002/ajh.23554},
  doi          = {10.1002/ajh.23554},
  volume       = {88},
  year         = {2013},
}