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European LeukemiaNet study on the reproducibility of bone marrow features in masked polycythemia vera and differentiation from essential thrombocythemia
Author(s) -
Kvasnicka Hans Michael,
Orazi Attilio,
Thiele Juergen,
Barosi Giovanni,
BuesoRamos Carlos E.,
Vannucchi Alessandro M.,
Hasserjian Robert P.,
Kiladjian JeanJacques,
Gianelli Umberto,
Silver Richard,
Mughal Tariq I.,
Barbui Tiziano
Publication year - 2017
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.24837
Subject(s) - medicine , polycythemia vera , essential thrombocythemia , myelofibrosis , bone marrow , myeloproliferative neoplasm , hematopathology , kappa , pathology , cytogenetics , chromosome , gene , biochemistry , chemistry , linguistics , philosophy
Abstract The purpose of the study was to assess consensus and interobserver agreement among an international panel of six hematopathologists regarding characterization and reproducibility of bone marrow (BM) histologic features used to diagnose early stage myeloproliferative neoplasms, in particular differentiation of so‐called masked/prodromal polycythemia vera (mPV) from JAK2 ‐mutated essential thrombocythemia (ET). The six members of the hematopathology panel evaluated 98 BM specimens independently and in a blinded fashion without knowledge of clinical data. The specimens included 48 cases of mPV according to the originally published hemoglobin threshold values for this entity (male: 16.0–18.4 g/dL, female: 15.0–16.4 g/dL), 31 cases with overt PV according to the updated 2016 WHO criteria, and 19 control cases. The latter group included cases of JAK2 ‐mutated ET, primary myelofibrosis, myelodysplastic syndrome, and various reactive conditions. Inter‐rater agreement between the panelists was very high (overall agreement 92.6%, kappa 0.812), particularly with respect to separating mPV from ET. Virtually all cases of mPV were correctly classified as PV according to their BM morphology. In conclusion, a central blinded review of histology slides by six hematopathologists demonstrated that highly reproducible specific histological pattern characterize PV and confirmed the notion that there are no significant differences between mPV and overt PV in relation to BM morphology.