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Central review reclassified about one-third of cases, with substantial shifts among MDS, MDS/MPN overlap, ICUS, AML with \u003C30% blasts, and other diagnoses. Site miscoding contributed over half of local errors, yielding an overall true misdiagnosis rate of 15% and 21% for MDS, with inappropriate therapy in 7% of misdiagnosed patients, affecting registry accuracy and treatment decisions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/discordant-pathologic-diagnoses-of-myelodysplastic-neoplasms-and-their-implications-for-registries-and-therapies/380538/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/discordant-pathologic-diagnoses-of-myelodysplastic-neoplasms-and-their-implications-for-registries-and-therapies/380538.png","ImageObject",300,407,{"name":92,"@type":93},"eBook King","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why are MDS pathologic diagnoses challenging in practice?","Question",{"text":113,"@type":114},"Diagnosis is difficult because interpretation of bone marrow morphology and quantification of dysplasia can vary between observers and sites, leading to discordant classifications.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was diagnostic discordance evaluated in this study?",{"text":118,"@type":114},"Local clinical site diagnoses were compared against central, adjudicated review from 918 participants enrolled in the National MDS Natural History Study.",{"name":120,"@type":111,"acceptedAnswer":121},"What are the clinical consequences of misdiagnosis in this setting?",{"text":122,"@type":114},"Miscoding and true misdiagnosis can lead to inappropriate therapy, with inappropriate treatment reported in 7% of misdiagnosed cases and lower therapy rates when local and central diagnoses truly disagreed.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},380538,1790305200,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962088006270,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","REGULAR ARTICLE  \nDiscordant pathologic diagnoses of myelodysplastic neoplasms and their implications for registries and therapies  \nEdward J. Gorak, 1 Michael Otterstatter,2 Tareq Al Baghdadi,3 Nancy Gillis,4 James M. Foran,5 Jane Jijun Liu,6 Rafael Bejar,7 Steven D. Gore,8 Steven H. Kroft,9 Alexandra Harrington,9 Wael Saber,9 Daniel Starczynowski, 10 Dana E. Rollison,4 Ling Zhang,4 Lynn Moscinski,4 Steffanie Wilson,2 Jason Thompson,2 Christine Borchert,2 Seth Sherman,2 Donnie Hebert,2 Mary Ellen Walker,4 Eric Padron,4 Amy E. DeZern, 11,* and Mikkael A. Sekeres 12,*  \n1 Division of Cancer Medicine, Baptist MD Anderson Cancer Center, Jacksonville, FL; 2The Emmes Corporation, Rockville, MD; 3 IHA Hematology Oncology, Ypsilanti, MI;  \n4 Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL; 5 Department of Hematology, Mayo Clinic, Jacksonville, FL; 6 Illinois CancerCare, Peoria, IL; 7 Moores Cancer Center, University of California San Diego, La Jolla, CA; 8 National Cancer Institute, Bethesda, MD; 9 Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI; 10 Division of Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; 11 Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD; and 12 Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL  \nKey Points  \n• Pathologic diagnosis of MDS can be challenging because of variability in interpretation of morphology and quantification of dysplasia.  \n• Misdiagnosis can lead to suboptimal treatment decisions and errors in population-based estimates of MDS incidence and mortality.  \nMyelodysplastic neoplasms (MDS) are a collection of hematopoietic disorders with widely variable prognoses and treatment options. Accurate pathologic diagnoses present challenges because of interobserver variability in interpreting morphology and quantifying dysplasia. We compared local clinical site diagnoses with central, adjudicated review from 918 participants enrolled in the ongoing National Heart, Lung, and Blood Institute National MDS Natural History Study, a prospective observational cohort study of participants with suspected MDS or MDS/myeloproliferative neoplasms (MPNs) . Locally, 264 (29%) were diagnosed as having MDS, 15 (2%) MDS/MPN overlap, 62 (7%) idiopathic cytopenia of undetermined significance (ICUS), 0 (0%) acute myeloid leukemia (AML) with \u003C30% blasts, and 577 (63%) as other. Approximately one-third of cases were reclassified after central review, with 266 (29%) diagnosed as MDS, 45 (5%) MDS/MPN overlap, 49 (5%) ICUS, 15 (2%) AML with \u003C30%, and 543 (59%) as other. Site miscoding errors accounted for more than half (53%) of the local misdiagnoses, leaving a true misdiagnosis rate of 15% overall, 21% for MDS. Therapies were reported in 37% of patients, including 43% of patients with MDS, 49% of patients with MDS/MPN, and 86% of patients withAML with \u003C30% blasts. Treatment rates were lower (25%) in cases with true discordance in diagnosis compared with those for whom local and central diagnoses agreed (40%), and receipt of inappropriate therapy occurred in 7% of misdiagnosed cases. Discordant diagnoses were frequent, which has implications for the accuracy of study-related and national registries and can lead to inappropriate therapy. This trial was registered at [www.clinicaltrials.gov](www.clinicaltrials.gov) as \\#NCT05074550 .  \nIntroduction  \nThe myelodysplastic neoplasms (MDS) are a heterogeneous collection of clonal, neoplastic hematopoietic disorders with widely variable prognoses and a propensity to evolve to acute myeloid leukemia  \nSubmitted 23 February 2023; accepted 17 July 2023; prepublished online on Blood Advances First Edition 8 August 2023. [https://doi.org/10.1182/](https://doi.org/10.1182/)[ ](https://doi.org/10.1182/)[bloodadvances.2023010061](bloodadvances.2023010061.)[.](bloodadvances.2023010061.)  \n*A.E.D. and M.A.S. are joint senior authors.  \nData from th","cbCail8zyJYXULYG","https://ap.wps.com/l/cbCail8zyJYXULYG","pdf",302229,"English","# Key Points\n## Diagnostic variability and discordance\n## Implications for registries and therapies\n# Introduction\n## Disease background and clinical importance\n## Classification frameworks and diagnostic challenges\n## Potential impact on population-based estimates","[{\"question\":\"Why are MDS pathologic diagnoses challenging in practice?\",\"answer\":\"Diagnosis is difficult because interpretation of bone marrow morphology and quantification of dysplasia can vary between observers and sites, leading to discordant classifications.\"},{\"question\":\"How was diagnostic discordance evaluated in this study?\",\"answer\":\"Local clinical site diagnoses were compared against central, adjudicated review from 918 participants enrolled in the National MDS Natural History Study.\"},{\"question\":\"What are the clinical consequences of misdiagnosis in this setting?\",\"answer\":\"Miscoding and true misdiagnosis can lead to inappropriate therapy, with inappropriate treatment reported in 7% of misdiagnosed cases and lower therapy rates when local and central diagnoses truly disagreed.\"}]","Discordant pathologic diagnoses of myelodysplastic neoplasms and their implications for registries and therapies | PDF",1790240593,25]