title: Implications of discrepancy in morphologic diagnosis of myelodysplastic syndrome between referral and tertiary care centers.
abstract: Patients referred to tertiary care centers occasionally may have their diagnostic procedures repeated and have a final diagnosis that differs from that of the referring center. The aim of this study was to evaluate discordance rates and their clinical implications in the diagnosis of patients with myelodysplastic syndrome (MDS) referred to a tertiary center. We analyzed 915 patients with MDS who were referred to M. D. Anderson Cancer Center between September 2005 and December 2009. Discordance in the diagnosis was documented in 109 (12%) patients, with a majority reclassified as having higher-risk disease by French-American-British (67%) or by International Prognostic Scoring System (77%) with implications for therapy selection and prognosis calculation. These results demonstrate the complexity of the diagnosis of MDS and highlight the need for confirmation of diagnosis when in doubt.
authors.affiliation: Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Kiran
authors.initials: K
authors.lastname: Naqvi
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
authors.forename: Carlos
authors.initials: C
authors.lastname: Bueso-Ramos
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Gautam
authors.initials: G
authors.lastname: Borthakur
authors.forename: Zeev
authors.initials: Z
authors.lastname: Estrov
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002173:Cancer Care Facilities / Q000592:standards; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000473:pathology*; D057089:Pathology, Molecular / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data; D012107:Research Design; D012189:Retrospective Studies