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WHO/ICC Classification for Myelodysplastic Neoplasms/Syndromes Performs Better for Subtype Cytomorphological Diagnosis?

Authors :
Vicente AI
Luna I
Ruiz JC
Remigia MJ
Jerez A
Lluch R
Llopis I
Marco MJ
Benet C
Alonso C
Linares MD
Serrano L
Orero MT
Ortuño FJ
Senent ML
Source :
Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2024 Jul 29; Vol. 14 (15). Date of Electronic Publication: 2024 Jul 29.
Publication Year :
2024

Abstract

The International Consensus Classification of Myeloid Neoplasms and Acute Leukemias (ICC) and the 5th edition of the WHO classification (WHO 2022) have refined the diagnosis of myelodysplastic syndromes (MDS). Both classifications segregate MDS subtypes based on molecular or cytogenetic findings but rely on the subjective assessment of blast cell percentage and dysplasia in hematopoietic cell lineages. This study aimed to evaluate interobserver concordance among 13 cytomorphologists from eight hospitals in assessing blast percentages and dysplastic features in 44 MDS patients. The study found fair interobserver agreement for the PB blast percentage and moderate agreement for the BM blast percentage, with the best concordance in cases with <5% BM blasts and >10% BM blasts. Monocyte count agreement was fair, and dysplasia assessment showed moderate concordance for megakaryocytic lineage but lower concordance for erythroid and granulocytic lineages. Overall, interobserver concordance for MDS subtypes was moderate across all classifications, with slightly better results for WHO 2022. These findings highlight the ongoing need for morphological evaluation in MDS diagnosis despite advances in genetic and molecular techniques. The study supports the blast percentage ranges established by the ICC but suggests refining BM blast cutoffs. Given the moderate interobserver concordance, a unified classification approach for MDS is recommended.

Details

Language :
English
ISSN :
2075-4418
Volume :
14
Issue :
15
Database :
MEDLINE
Journal :
Diagnostics (Basel, Switzerland)
Publication Type :
Academic Journal
Accession number :
39125507
Full Text :
https://doi.org/10.3390/diagnostics14151631