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The recent revision of the World Health Organization (WHO) classification of myeloid neoplasms 4th edition has generated two separate classification schemes for the diagnosis of myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN); the International Consensus Classification (ICC) and the WHO classification 5th edition both provide valuable diagnostic guidance for healthcare professionals; however, diagnostic discordance may arise from the application of different classification models.
Recently, Benton et al.1 published a report in Journal of Clinical Pathology reviewing 64 patients diagnosed with MPN/MDS using both schemes and assessing diagnostic inconsistencies to highlight significant differences between the models. Here, we highlight the key findings in the article.
Figure 1. Patient cases with nominal diagnostic differences*
ET, essential thrombocythemia; ICC, International Consensus Classification; MDS, myelodysplastic syndrome; MPN, myeloproliferative neoplasm; pCT, post cytotoxic therapy; RS, ringed sideroblasts; T, thrombocytosis; TRMN, treatment-related myeloid neoplasm; U, unclassifiable; WHO, World Health Organization.
*Adapted from Benton, et al.1
Figure 2. Patient case with a significant diagnostic difference*
CML, chronic myeloid leukemia; ICC, International Consensus Classification; MDS, myelodysplastic syndrome; MPN, myeloproliferative neoplasm; N, neutrophilia; U, unclassifiable; WHO, World Health Organization.
*Adapted from Benton, et al.1
Although not immediately clinically significant, the diagnostic discrepancies highlighted have the potential to increase physician workload and cause unnecessary confusion for healthcare professionals and patients alike. There is potential for long-term challenges to arise which will impact on clinical trial eligibility and treatment disparities. Resolution of these issues is important to avoid confusion and ensure standardized practices, enabling optimal patient outcomes.
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