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Misdiagnosis Common for Suspected Myelodysplastic Neoplasms

About one-third of cases were reclassified following central review; receipt of inappropriate meds reported in 7 percent of misdiagnosed cases

By Elana Gotkine HealthDay Reporter

FRIDAY, Aug. 11, 2023 (HealthDay News) — For patients with suspected myelodysplastic neoplasms (MDS), diagnoses are often discordant for local clinical sites and central, adjudicated review, according to a study published online Aug. 8 in Blood Advances.

Edward J. Gorak, D.O., from the Baptist MD Anderson Cancer Center in Jacksonville, Florida, and colleagues compared local clinical site diagnoses with central, adjudicated review from 918 participants enrolled in a prospective observational cohort study of participants with suspected MDS or MDS/myeloproliferative neoplasms (MPNs).

The researchers found that locally, 29 percent were diagnosed with MDS, 2 percent with MDS/MPN overlap, 7 percent with idiopathic cytopenia of undetermined significance (ICUS), 0 percent with acute myeloid leukemia (AML) with <30 percent blasts, and 63 percent with other. Following central review, about one-third of cases were reclassified, with 29, 5, 5, 2, and 59 percent diagnosed with MDS, MDS/MPN overlap, ICUS, AML <30 percent, and other, respectively. More than half of the local misdiagnoses were due to site miscoding errors (53 percent), leaving a true misdiagnosis rate of 15 percent overall and 21 percent for MDS. Thirty-seven percent of patients had therapies, with treatment rates lower in cases with true discordance in diagnoses versus those where local and central diagnoses agreed (25 versus 40 percent); in 7 percent of misdiagnosed cases, receipt of inappropriate therapy occurred.

“Our findings highlight the vital importance of seeking expert opinions from National Cancer Institute-designated cancer centers, especially with rare blood and bone marrow cancers such as MDS,” corresponding author Mikkael Sekeres, M.D., of the Sylvester Comprehensive Cancer Center at the University of Miami, said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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