High concordance in grading reticulin fibrosis and cellularity in patients with myeloproliferative neoplasms

The importance of central pathology review in international trials: a comparison of local versus central bone marrow reticulin grading

“…Table 2 shows the frequency of agreement on each individual BMF grade between the central and local review for all trials. Similar to a prior study examining grading concordance among expert hematopathologists, 14 the highest rate of agreement between local grade and central review grade was seen for central grade 3 (72%), with central grade 1 showing the lowest agreement rate with the local pathologist's grade (37%). We also found a bias towards under-or over-grading of local compared to central pathologists in different countries: compared to other countries, grading by local pathologists in France (P o 0.0001) and Portugal (P = 0.03) was lower than the central panel, while local pathologist grading in the United States was higher than the central panel (P o0.0001).…”

“…As previously described, grading of BMF by both central review and the local pathologists was according to the 2008 WHO classification guidelines, with four possible grades (0, 1, 2 and 3). 14 The central review panel consisted of three hematopathologists (OP, RPH, JT), who examined hematoxylin and eosin, silver impregnation-reticulin and trichrome stains. For the Phase 2 and 3 trials, the central review grading was made on stains performed at Covance Central Laboratory (Indianapolis, IN, USA) according to the manufacturer's protocols, on unstained slides submitted by the participating institutions.…”

Limitations of fibrosis grade as diagnostic criteria for post polycythemia vera and essential thrombocytosis myelofibrosis

“…Prior studies suggest intraobserver variability between marrow assessments exist and results may not be consistent [35,36]. However, other studies have disputed this and show great reliability amongst observer assessments [37,38]. In future studies, a centralized marrow review with at least two pathologists would strengthen the results.…”

Advances and challenges in the management of essential thrombocythemia

“…A recent study found good concordance in establishing the diagnosis (kappa index 0.67) and a high specificity of histopathological changes (98.5%), whereas the sensitivity was rather low (54%) [Alvarez-Larran, 2014a]. Several studies now support both feasibility and usefulness of the WHO ET and early PMF definitions, and it is to be expected that prospective studies from now on will use it [Gianelli et al 2006[Gianelli et al , 2008[Gianelli et al , 2013[Gianelli et al , 2014a 2014b; Thiele et al 2011;Pozdnyakova et al 2014]. A recent paper summarizes the discussion of this issue [Barbui et al 2013].…”