Current pathology practices in and barriers to MDS diagnosis |
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Authors: | Terry Ann Glauser Elizabeth M Sagatys J Chad Williamson B Stephen Burton Christine Berger Patti Merwin Mary Sugrue John M Bennett |
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Institution: | 1. CE Outcomes, LLC, Birmingham, AL, United States;2. H Lee Moffitt Cancer Center, Tampa, FL, United States;3. Celgene Corporation, Summit, NJ, United States;4. Department of Medicine and Pathology, James P. Wilmot Cancer Center and Hematopathology Division, University of Rochester Medical Center, United States |
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Abstract: | Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic stem cell malignancies that represent a diagnostic challenge for pathologists. Accurate classification and prognostic scoring are essential to treating MDS. To understand factors that affect MDS management, a case-based survey was distributed to hematopathologists (n = 53) and general pathologists (n = 72) to identify perceived barriers, attitudes, and practices in MDS diagnosis. Results demonstrated confidence and practice gaps. Only 33% of general pathologists are confident in diagnosing MDS. Neither general pathologists nor hematopathologists are comfortable using the International Prognostic Scoring System to characterize risk. Thirty percent of general pathologists and 22% of hematopathologists would not include bone marrow aspirate and cytogenetics in initial testing of a neutropenic patient. Most practitioners tested appropriately for disease classification and prognosis; discrepancies were identified in testing to differentiate MDS from acute myeloid leukemia and testing in post treatment specimens. These results have implications in the management of MDS. |
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Keywords: | Myelodysplastic syndromes Acute myeloid leukemia Pathology Hematopathology Physician practice patterns Practice gaps |
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