Interobserver concordance of assessments of dysplasia and blast counts for the diagnosis of patients with cytopenia: From the Japanese central review study

Akira Matsuda; Hiroshi Kawabata; Kaoru Tohyama; Tomoya Maeda; Kayano Araseki; Tomoko Hata; Takahiro Suzuki; Hidekazu Kayano; Kei Shimbo; Kensuke Usuki; Shigeru Chiba; Takayuki Ishikawa; Nobuyoshi Arima; Masaharu Nohgawa; Akiko Ohta; Yasushi Miyazaki; Sinnji Nakao; Keiya Ozawa; Shunya Arai; Mineo Kurokawa; Kinuko Mitani; Akifumi Takaori-Kondo; Japanese National Research Group on Idiopathic Bone Marrow Failure Syndromes

doi:10.1016/j.leukres.2018.06.003

Interobserver concordance of assessments of dysplasia and blast counts for the diagnosis of patients with cytopenia: From the Japanese central review study

Leuk Res. 2018 Nov:74:137-143. doi: 10.1016/j.leukres.2018.06.003. Epub 2018 Jun 7.

Authors

Akira Matsuda¹, Hiroshi Kawabata², Kaoru Tohyama³, Tomoya Maeda⁴, Kayano Araseki⁵, Tomoko Hata⁶, Takahiro Suzuki⁷, Hidekazu Kayano⁸, Kei Shimbo⁹, Kensuke Usuki¹⁰, Shigeru Chiba¹¹, Takayuki Ishikawa¹², Nobuyoshi Arima¹³, Masaharu Nohgawa¹⁴, Akiko Ohta¹⁵, Yasushi Miyazaki⁶, Sinnji Nakao¹⁶, Keiya Ozawa¹⁷, Shunya Arai¹⁸, Mineo Kurokawa¹⁸, Kinuko Mitani¹⁹, Akifumi Takaori-Kondo²⁰; Japanese National Research Group on Idiopathic Bone Marrow Failure Syndromes

Affiliations

¹ Department of Hemato-Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan. Electronic address: amatsu@saitama-med.ac.jp.
² Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
³ Department of Laboratory Medicine, Kawasaki Medical School, Okayama, Japan.
⁴ Department of Hemato-Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.
⁵ Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Saitama Medical University, Moroyama, Saitama, Japan.
⁶ Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
⁷ Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan; Department of Hematology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
⁸ School of Medical Technology, Faculty of Health and Medical Care, Saitama Medical University, Hidaka, Saitama, Japan.
⁹ Clinical Laboratory Center, Dokkyo Medical University Hospital, Mibu, Tochigi, Japan.
¹⁰ Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan.
¹¹ Department of Hematology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
¹² Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
¹³ Department of Hematology, Medical Research Institute Kitano Hospital, Osaka, Japan.
¹⁴ Department of Hematology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
¹⁵ Division of Public Health, Department of Social Medicine, Saitama Medical University Faculty of Medicine, Moroyama, Saitama, Japan.
¹⁶ Department of Haematology, Faculty of Medicine, Kanazawa University Institutes of Medical, Pharmaceutical, and Health Sciences, Kanazawa, Ishikawa, Japan.
¹⁷ Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan; The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
¹⁸ Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹⁹ Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan.
²⁰ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

PMID: 29914726
DOI: 10.1016/j.leukres.2018.06.003

Abstract

The diagnosis of myelodysplastic syndromes (MDS) is based on morphology and cytogenetics. However, limited information is currently available on the interobserver concordance of the assessment of dysplastic lineages (<10% or ≥10% in bone marrow (BM)). The revised International Prognostic Scoring System (IPSS-R) described a new threshold (2%) for BM blasts. However, the interobserver concordance of the categories (0-≤2% and >2-<5%) has limited data. The purpose of the present study was to investigate the assessment of dysplastic lineages and IPSS-R reproducibility. Our study was divided into two Steps. In each Step, the microscopic examinations were performed separately by two morphologists. Regarding the category of BM blasts ≤2% and >2-<5%, interobserver agreement was more than 'moderate' in all pairs (kappa test: 0.43-0.90). Regarding dysgranulopoiesis (dysG) and dyserythropoiesis (dysE) in BM, interobserver agreement was more than 'moderate' in all pairs (kappa test, dysG: 0.45-0.96, dysE: 0.45-0.81). Regarding the category of dysmegakaryopoiesis (dysMgk) in BM, interobserver agreement was more than moderate in 4 out of 5 pairs (kappa test: 0.58-1.00), and was fair for one pair (kappa test: 0.37). We consider that high interobserver concordance may be possible for the BM blast cell count (≤2% or >2-<5%) and dysplasia (<10% or ≥10%) of each lineage.

Keywords: Aplastic anemia; Dysplasia; Interobserver concordance; Myeloblasts; Myelodysplastic syndromes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blast Crisis / pathology*
Cell Count
Female
Humans
Japan
Male
Myelodysplastic Syndromes / pathology*
Observer Variation
Registries*