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Discordant pathologic diagnoses of myelodysplastic neoplasms and their implications for registries and therapies.
Gorak, Edward J; Otterstatter, Michael; Al Baghdadi, Tareq; Gillis, Nancy; Foran, James M; Liu, Jane Jijun; Bejar, Rafael; Gore, Steven D; Kroft, Steven H; Harrington, Alexandra; Saber, Wael; Starczynowski, Daniel; Rollison, Dana E; Zhang, Ling; Moscinski, Lynn; Wilson, Steffanie; Thompson, Jason; Borchert, Christine; Sherman, Seth; Hebert, Donnie; Walker, Mary Ellen; Padron, Eric; DeZern, Amy E; Sekeres, Mikkael A.
Afiliação
  • Gorak EJ; Division of Cancer Medicine, Baptist MD Anderson Cancer Center, Jacksonville, FL.
  • Otterstatter M; The Emmes Corporation, Rockville, MD.
  • Al Baghdadi T; IHA Hematology Oncology, Ypsilanti, MI.
  • Gillis N; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL.
  • Foran JM; Department of Hematology, Mayo Clinic, Jacksonville, FL.
  • Liu JJ; Illinois CancerCare, Peoria, IL.
  • Bejar R; Moores Cancer Center, University of California San Diego, La Jolla, CA.
  • Gore SD; National Cancer Institute, Bethesda, MD.
  • Kroft SH; Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI.
  • Harrington A; Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI.
  • Saber W; Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI.
  • Starczynowski D; Division of Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
  • Rollison DE; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL.
  • Zhang L; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL.
  • Moscinski L; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL.
  • Wilson S; The Emmes Corporation, Rockville, MD.
  • Thompson J; The Emmes Corporation, Rockville, MD.
  • Borchert C; The Emmes Corporation, Rockville, MD.
  • Sherman S; The Emmes Corporation, Rockville, MD.
  • Hebert D; The Emmes Corporation, Rockville, MD.
  • Walker ME; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL.
  • Padron E; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL.
  • DeZern AE; Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD.
  • Sekeres MA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL.
Blood Adv ; 7(20): 6120-6129, 2023 10 24.
Article em En | MEDLINE | ID: mdl-37552083
ABSTRACT
Myelodysplastic neoplasms (MDS) are a collection of hematopoietic disorders with widely variable prognoses and treatment options. Accurate pathologic diagnoses present challenges because of interobserver variability in interpreting morphology and quantifying dysplasia. We compared local clinical site diagnoses with central, adjudicated review from 918 participants enrolled in the ongoing National Heart, Lung, and Blood Institute National MDS Natural History Study, a prospective observational cohort study of participants with suspected MDS or MDS/myeloproliferative neoplasms (MPNs). Locally, 264 (29%) were diagnosed as having MDS, 15 (2%) MDS/MPN overlap, 62 (7%) idiopathic cytopenia of undetermined significance (ICUS), 0 (0%) acute myeloid leukemia (AML) with <30% blasts, and 577 (63%) as other. Approximately one-third of cases were reclassified after central review, with 266 (29%) diagnosed as MDS, 45 (5%) MDS/MPN overlap, 49 (5%) ICUS, 15 (2%) AML with <30%, and 543 (59%) as other. Site miscoding errors accounted for more than half (53%) of the local misdiagnoses, leaving a true misdiagnosis rate of 15% overall, 21% for MDS. Therapies were reported in 37% of patients, including 43% of patients with MDS, 49% of patients with MDS/MPN, and 86% of patients with AML with <30% blasts. Treatment rates were lower (25%) in cases with true discordance in diagnosis compared with those for whom local and central diagnoses agreed (40%), and receipt of inappropriate therapy occurred in 7% of misdiagnosed cases. Discordant diagnoses were frequent, which has implications for the accuracy of study-related and national registries and can lead to inappropriate therapy. This trial was registered at www.clinicaltrials.gov as #NCT05074550.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndromes Mielodisplásicas / Leucemia Mieloide Aguda / Transtornos Mieloproliferativos Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Blood Adv Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndromes Mielodisplásicas / Leucemia Mieloide Aguda / Transtornos Mieloproliferativos Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Blood Adv Ano de publicação: 2023 Tipo de documento: Article
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