World Health Organization-defined classification of myeloproliferative neoplasms: morphological reproducibility and clinical correlations--the Danish experience
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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; Dahl-Sørensen, Rasmus; Mortensen, Nana Brochmann; Svendsen, Kira Dynnes; Lange, Theis; Ralfkiaer, Elisabeth; Nielsen, Karsten; Hasselbalch, Hans Carl; Thiele, Jürgen.
In: American Journal of Hematology, Vol. 88, No. 12, 12.2013, p. 1012-1016.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - World Health Organization-defined classification of myeloproliferative neoplasms
T2 - morphological reproducibility and clinical correlations--the Danish experience
AU - Madelung, Ann Brinch
AU - Bondo, Henrik
AU - Stamp, Inger
AU - Loevgreen, Preben
AU - Nielsen, Signe Ledou
AU - Falensteen, Anne
AU - Knudsen, Helle
AU - Ehinger, Mats
AU - Dahl-Sørensen, Rasmus
AU - Mortensen, Nana Brochmann
AU - Svendsen, Kira Dynnes
AU - Lange, Theis
AU - Ralfkiaer, Elisabeth
AU - Nielsen, Karsten
AU - Hasselbalch, Hans Carl
AU - Thiele, Jürgen
N1 - Copyright © 2013 Wiley Periodicals, Inc.
PY - 2013/12
Y1 - 2013/12
N2 - 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
AB - 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
KW - Aged
KW - Bone Marrow
KW - Bone Marrow Examination
KW - Consensus
KW - Denmark
KW - Female
KW - Humans
KW - Laboratory Proficiency Testing
KW - Male
KW - Middle Aged
KW - Myeloproliferative Disorders
KW - Observer Variation
KW - Pathology Department, Hospital
KW - Pathology, Clinical
KW - Random Allocation
KW - Reproducibility of Results
KW - Single-Blind Method
KW - Sweden
KW - World Health Organization
U2 - 10.1002/ajh.23554
DO - 10.1002/ajh.23554
M3 - Journal article
C2 - 23897670
VL - 88
SP - 1012
EP - 1016
JO - American Journal of Hematology
JF - American Journal of Hematology
SN - 0361-8609
IS - 12
ER -
ID: 117911590