1 / 10

Morphology substudy ELN low risk Registry

Morphology substudy ELN low risk Registry. Aims - assess the reproducibility of diagnosis Methods - review of random selected slides from all participating countries - reviewer panel includes both „ experts “ as well as physicians in training

JasminFlorian
Télécharger la présentation

Morphology substudy ELN low risk Registry

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Morphology substudy ELN low risk Registry Aims - assessthereproducibility of diagnosis Methods - review of randomselectedslidesfrom all participating countries - reviewerpanelincludesboth „experts“ as well asphysicians in training - description of resultsandcorrelationwith original findings - calculation of degree of discrepancyusingk-test

  2. Methods in detail • Random selection of a total of 100 casesfrom all countries • takingintoaccounttheamount of includedpatients • (forexamplemorefrom France ascomparedto Germany • -> alreadydoneby Alex Smith • 2 marrowslides (preferably also ironstaining) and 1 blood film fromeachselectedcaseshouldbesentto Düsseldorf, wherethemorphologyreview will takeplace • > actionbycountrycoordinators

  3. Methods in detail • Preparation of minimal requireddataset of selectedcasesnecessaryforreview, tobesenttoDüsseldorf: - ID, (Country, Hospital: onlyavailableto Alex Smith) - ageatdiagnosis - Hb, WBC, Platelets, Defferentialcount, LDH, Bilirubin, Coombs test - cytogeneticfindingatdiagnosis: necessaryfor WHO classification - no original morphologyreport -> tobedoneby Alex Smith

  4. Morphology assessment in detail • Description of Morphologic characeristics, • to be filled in a file during the morphology meeting • Peripheral blood • - % of blasts • - % of monocytes • - signs of Dysplasia • - Anisometry of platelts? • - Macroplatelets? • - Pseudopelger? • - Hypogranulation? • - cytoplasma anomalies of erythrocytes?

  5. Morphology assessment in detail • Description of Morphologic characeristics, • to be filled in a file during the morphology meeting • II) Marrow • Erythropoiesis • % of erythropoiesis • Clear signs of dysplasia? • Nuclear abnormalities? • Cytoplasma abnormalities? • Ring sideroblasts? (%) • Megakaryopoiesis • - Assessment of 25 megakaryocytes • Clear signs of dysplasia? (>10%) • Micromegakaryocytes ? • Mononuclear megakaryocytes? • Megas with spreaded nuclei?

  6. Morphology assessment in detail • Description of Morphologic characeristics • Granulopoiesis • - Clear signs of dysplasia? (>10%) • Pseudopelger? • Hypogranulation? • % Medullary blast (if Erythropoiesis >50%, count blasts in the non-erythropoietic cells) • Other items • - Cellularity (Hypo vs. Normo vs. Hyper) • Plasma cells increased? • Lymphoid cells increased? • Iron load? • Other stainings available?

  7. Morphology assessment in detail Diagnosticcategories RCUD (bicytopenia) RC RA RN MDS unclass RCUD withpancytopenia RCUD/RCMD withblasts in blood RCUD withoutdysplasia but withclonalmarker RCMD MDS with del(5q) RARS-T RAEB I RAEB II, RAEB-T, AML, CMML I, CMMLII, ICUS No MDS at all

  8. Methods to analyse the results • Within the panel • - Discussion of cases during meeting • - Report on interobserver variation within experts • - Report on possible discrepancies between „experts“ and „non-experts“ • - description of staining techniques and quality of slides • - comparison of methods to read the slides • - correlation of WHO types with hematologic and cytogenetic findings • 2) Panel vs. Original reports • - Send list of WHO results of the morphology panel to Alex Smith • - Comparison of original reports with the results of the panel by • k-test (and/or other tests to be done my Alex Smith) to describe • amount of discrepancies • 3) Final report on • - Validation and reliability of the cases included into the ELN low risk R

  9. Methods to analyse the results • 3) Final report on • - Validation andreliability of thecasesincludedintothe ELN lowriskRegistry tobedonewithinthepaneland Alex Smith

  10. Morphology Panel • Chairs: Ulrich Germingand Marius MacKenzie • ProposedExperts • Argiris Symenoidis, Greece • Jaroslaw Cermak, Czech Rep. • Anna Porwit, Sweden • Teresa Valespie?, Spain • Proposed „non-experts“ • Louise deSwart, Netherlands • Judith Neukirchen, Germany • By David Bowen, UK • Others

More Related