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Implications of discrepancy in morphologic diagnosis of myelodysplastic syndrome between referral and tertiary care centers

Kiran Naqvi, Elias Jabbour, Carlos Bueso-Ramos, Sherry Pierce, Gautam Borthakur, Zeev Estrov, Farhad Ravandi, Stefan Faderl, Hagop Kantarjian and Guillermo Garcia-Manero

Article Figures & Data

Figures

  • Figure 1

    Discordance between referral diagnoses and final diagnoses at MDACC. (A) By French-American-British. RA indicates refractory anemia; RARS, refractory anemia with ring sideroblasts; RCMD, refractory cytopenia with multilineage dysplasia; RCMD-RS, refractory cytopenia with multilineage dysplasia with ringed sideroblasts; CMML, chronic myelomonocytic leukemia; MDS-U, myelodysplastic syndrome unclassifiable; AML, acute myelogenous leukemia; others, chronic myeloid leukemia, myelofibrosis, normal bone marrow; and pts, patients. (B) By International Prognostic Scoring System (IPSS). Nonapplicable includes referral diagnosis of AML, chronic lymphocytic leukemia, CMML, myelofibrosis, or normal bone marrow examination. Pts indicates patients.

Tables

  • Table 1

    Comparison of bone marrow blasts percentage between referral center and MDACC in 76 patients in whom outside slides were available

    Referral BM blasts, %MDACC BM blasts, %
    < 55-1011-20> 20Total
    < 50228232
    5-10803314
    11-202101821
    > 2000303
    NA32106
    Total1325152376
    • Blast differences were based on counting the same slides when available.

    • BM indicates bone marrow; and NA, not applicable.

  • Table 2

    Comparison of patient characteristics between the discordant and nondiscordant groups

    CharacteristicNondiscordantDiscordantTotalP
    n%n%
    Age
        < 60 y209263532244.17
        ≥ 60 y597747468671
    Sex
        Female308384037348.76
        Male498626963567
    Diagnosis
        RA/RARS/RCMD/RCMD-RS355441614371< .001*
        RAEB316394339359
        RAEB-T86114642132
        MDS-U3243335
        5q−1420014
        CMML20.2113
        AML10.1001
    IPSS
        Low1612076168< .001*
        Intermediate-1291362826319
        Intermediate-2196242826224
        High102134037142
        Not applicable5676562
    Cytogenetics
        Diploid343434441387.87
        −5/−7231293532266
        Other162202220184
        Insufficient metaphases7088778
    WBC
        <10740929890838.47
        ≥ 10617111072
        Information not available51005
    Platelet
        < 100488607972567.05*
        ≥ 100313393028343
        Information not available51005
    Hemoglobin
        <10428537670504.004*
        ≥ 10373463330406
        Information not available51005
    Marrow blasts
        0-4436541817454< .001*
        5-10162203229194
        11-20115142523140
         > 20648333097
        Not done/not applicable2941130
    Transformation to AML
        Yes75910985.96
        No731919991830
    • * Statistically significant (P = .05).