Madelung, Ann Brinch, Bondo, Henrik, Stamp, Inger, Loevgreen, Preben, Nielsen, Signe Ledou, Falensteen, Anne, Knudsen, Helle, Ehinger, Mats ORCID: 0000-0003-2342-1679, Dahl-Sorensen, Rasmus, Mortensen, Nana Brochmann, Svendsen, Kira Dynnes, Lange, Theis ORCID: 0000-0001-6807-8347, Ralfkiaer, Elisabeth, Nielsen, Karsten, Hasselbalch, Hans Carl and Thiele, Juergen (2013). World Health Organization-defined classification of myeloproliferative neoplasms: Morphological reproducibility and clinical correlations-The Danish experience. Am. J. Hematol., 88 (12). S. 1012 - 1017. HOBOKEN: WILEY. ISSN 1096-8652

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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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Madelung, Ann BrinchUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bondo, HenrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stamp, IngerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loevgreen, PrebenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nielsen, Signe LedouUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Falensteen, AnneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knudsen, HelleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ehinger, MatsUNSPECIFIEDorcid.org/0000-0003-2342-1679UNSPECIFIED
Dahl-Sorensen, RasmusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mortensen, Nana BrochmannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Svendsen, Kira DynnesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lange, TheisUNSPECIFIEDorcid.org/0000-0001-6807-8347UNSPECIFIED
Ralfkiaer, ElisabethUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nielsen, KarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasselbalch, Hans CarlUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thiele, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-471296
DOI: 10.1002/ajh.23554
Journal or Publication Title: Am. J. Hematol.
Volume: 88
Number: 12
Page Range: S. 1012 - 1017
Date: 2013
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1096-8652
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ESSENTIAL THROMBOCYTHEMIA; THROMBIN GENERATION; POLYCYTHEMIA-VERA; PLATELET; JAK2; MUTATION; MICROPARTICLES; ACTIVATION; MARKERS; HEMORRHAGEMultiple languages
HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/47129

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