title: Reproducibility of the WHO histological criteria for the diagnosis of Philadelphia chromosome-negative myeloproliferative neoplasms.
abstract: This study, performed on behalf of the Italian Registry of Thrombocythaemias (Registro Italiano Trombocitemie), aimed to test the inter-observer reproducibility of the histological parameters proposed by the WHO classification for the diagnosis of the Philadelphia chromosome-negative myeloproliferative neoplasms. A series of 103 bone marrow biopsy samples of Philadelphia chromosome-negative myeloproliferative neoplasms consecutively collected in 2004 were classified according to the WHO criteria as follows: essential thrombocythaemia (n=34), primary myelofibrosis (n=44) and polycythaemia vera (n=25). Two independent groups of pathologists reviewed the bone marrow biopsies. The first group was asked to reach a collegial 'consensus' diagnosis. The second group reviewed individually all the cases to recognize the main morphological parameters indicated by the WHO classification and report their results in a database. They were subsequently instructed to individually build a 'personal' diagnosis of myeloproliferative neoplasms subtype just assembling the parameters collected in the database. Our results indicate that high levels of agreement (≥70%) have been reached for about all of the morphological features. Moreover, among the 18 evaluated histological features, 11 resulted statistically more useful for the differential diagnosis among the different Philadelphia chromosome-negative myeloproliferative neoplasms. Finally, we found a high percentage of agreement (76%) between the 'personal' and 'consensus' diagnosis (Cohen's kappa statistic >0.40). In conclusion, our results support the use of the histological criteria proposed by the WHO classification for the Philadelphia chromosome-negative myeloproliferative neoplasms to ensure a more precise and early diagnosis for these patients.
authors.affiliation: UOC di Anatomia Patologica, Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Gianelli
authors.affiliation: Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milano, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Bossi
authors.affiliation: Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milano, Italy.
authors.forename: Ivan
authors.initials: I
authors.lastname: Cortinovis
authors.affiliation: Unità Operativa di Emolinfopatologia, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi, Bologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Sabattini
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno-Infantile 'G. D'Alessandro', Sezione di Anatomia Patologica, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Tripodo
authors.affiliation: Struttura Complessa di Anatomia Patologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Boveri
authors.affiliation: UOC di Anatomia Patologica, Azienda Ospedaliera San Paolo, Milano, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Moro
authors.affiliation: UOC di Anatomia Patologica, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Valli
authors.affiliation: UOC di Anatomia Patologica, Dipartimento di Oncologia, Istituto Scientifico San Raffaele, Milano, Italy.
authors.forename: Maurilio
authors.initials: M
authors.lastname: Ponzoni
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno-Infantile 'G. D'Alessandro', Sezione di Anatomia Patologica, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Ada
authors.initials: A
authors.lastname: M Florena
authors.affiliation: Anatomia Patologica Ospedaliera ed Universitaria, IRCCS San Martino-IST Genova, Genova, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: F Orcioni
authors.affiliation: Istituto di Anatomia Patologica, Università degli Studi di Perugia, Azienda Ospedaliera S. Maria, Terni, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ascani
authors.affiliation: UOC di Anatomia Patologica, Ospedale 'A. Manzoni', Lecco, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bonoldi
authors.affiliation: U.O.C. di Ematologia, Centro Trapianti di Midollo Osseo, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Iurlo
authors.affiliation: Istituto di Ematologia 'L. e A. Seragnoli', Policlinico S.Orsola-Malpighi, Bologna, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Gugliotta
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno-Infantile 'G. D'Alessandro', Sezione di Anatomia Patologica, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Franco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010677:Philadelphia Chromosome; D011087:Polycythemia Vera / Q000175:diagnosis* / Q000453:epidemiology; D055728:Primary Myelofibrosis / Q000175:diagnosis* / Q000453:epidemiology; D015203:Reproducibility of Results; D013920:Thrombocythemia, Essential / Q000175:diagnosis* / Q000453:epidemiology; D014944:World Health Organization; D055815:Young Adult