Cytomorphology review of 100 newly diagnosed lower-risk MDS patients in the European LeukemiaNet MDS (EUMDS) registry reveals a high inter-observer concordance

Objectives To examine contemporary survival patterns in the general population of patients diagnosed with chronic myeloid leukaemia (CML), and to identify patient groups with less than optimal outcomes. Design Prospective population-based cohort. Setting The UK's Haematological Malignancy Research Network (catchment population 3.6 million, with >2000 new haematological malignancies diagnosed annually). Participants All patients newly diagnosed with CML, from September 2004 to August 2011 and followed up to 31 March 2013. Main outcome measure Incidence and survival. Results With a median diagnostic age of 59 years, the CML age standardised (European) incidence was 0.9/100 000 (95% CIs 0.8 to 0.9), 5-year overall survival was 78.9% (72.3 to 84.0) and 5-year relative survival 88.6% (81.0 to 93.3). The efficacy of treatment across all ages was clearly demonstrated; the relative survival curves for those under 60 and over 60 years being closely aligned. Survival findings were similar for men and women, but varied with deprivation; the age and sex adjusted HR being 3.43 (1.89 to 6.22) for deprivation categories 4–5 (less affluent) versus 1–3 (more affluent). None of these differences were attributable to the biological features of the disease. Conclusions When therapy is freely provided, population-based survival for CML is similar to that reported in clinical trials, and age loses its prognostic significance. However, although most of the patients with CML now experience close to normal lifespans, those living in more deprived areas tend to have poorer outcomes, despite receiving the same clinical care. A significant improvement in overall population outcomes could be achieved if these socioeconomic differences, which may reflect the treatment compliance, could be eliminated

Cambios sociales y género

Resumen basado en el de la publicaciónSe presenta una propuesta para adaptar los contenidos de la optativa 'Cambios sociales y género' al aula. Se trata de un trabajo colectivo realizado por docentes que imparten esta materia o realizan funciones de asesoría en educación. Tiene un formato común para darle la unidad necesaria al conjunto y hacer más fácil el trabajo de equipo en su elaboración, contiene una guía para el profesorado con sugerencias metodológicas, bibliografía y webgrafía para facilitar el trabajo en el aula. El formato digital abre la puerta a su adaptabilidad al uso de las Tecnologías de la Información y la Comunicación (TIC) como herramientas vehiculares en el desarrollo de esta materia.AndalucíaES

Quality Control Initiative on the Evaluation of the Dysmegakaryopoiesis in Myeloid Neoplasms: Difficulties in the Assessment of Dysplasia

International audienceEvaluation of megakaryocyte morphology is difficult but can be essential for the diagnosis of myelodysplastic syndromes (MDS) and other myeloid neoplasms. We agreed upon descriptions and provided images of megakaryoblasts and of normal and dysplastic megakaryocytes, which were used as a basis for assessing the concordance of expert morphologists in their recognition. We showed a high rate of concordance for the recognition of micromegakaryocytes and confirmed their strong association with hematologic neoplasia, including MDS. Concordance was also found to be good for the recognition of multinucleated megakaryocytes, which showed a significant association with MDS. However cytoplasmic abnormalities were found not to be useful in MDS recognition. The occurrence of appreciable numbers of nonlobulated and hypolobulated megakaryocytes in individuals without a myeloid neoplasm was confirmed. We demonstrated that subjects without a myeloid neoplasm can have some megakaryocytes that are assessed as ‘dysplastic’ or ‘possibly dysplastic’ and that to avoid over diagnosis of dysplasia, ‘possibly dysplastic’ forms should be excluded from the count of dysplastic cells. Our results demonstrate that the nature as well as the presence of megakaryocyte dysplasia is important in the diagnosis of MDS; although evaluation of 30 megakaryocytes is strongly recommended, it may be possible to recognize diagnostically important dysplasia when fewer megakaryocytes are present but highly diagnostic forms are seen

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Resumen basado en el de la publicaciónSe desarrollan las medidas contempladas en el Plan de Igualdad entre Hombres y Mujeres en la Educación para hacer cada vez más real y efectivo el derecho a la igualdad entre todos los seres humanos, para poner en valor la contribución de las mujeres al desarrollo de las sociedades, y para eliminar, desde nuestras competencias en educación, aquellos presupuestos, costumbres y prácticas que invisibilizan, minusvaloran o discriminan a las mujeres. Se sigue la estructura siguiente: biografías de mujeres, en las que se puede observar la pluralidad de experiencias femeninas, los diversos itinerarios vitales seguidos por las mujeres en diferentes momentos de la historia, a lo que se añaden una serie de propuestas de actividades, bibliografía y enlaces web.AndalucíaBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Fluorescence in situ hybridization (FISH) of TP53 for the detection of chromosome 17 abnormalities in myelodysplastic syndromes

Conventional G-banding cytogenetics (CC) detects chromosome 17 (chr17) abnormalities in 2% of patients with de novo myelodysplastic syndromes (MDS). We used CC and fluorescence in situ hybridization (FISH) (LSI p53/17p13.1) to assess deletion of 17p in 531 patients with de novo MDS from the Spanish Group of Hematological Cytogenetics. FISH detected17 or 17p abnormalities in 13 cases (2.6%) in whom no 17p abnormalities were revealed by CC: 9% of patients with a normal karyotype, 0% in non-informative cytogenetics, 50% of patients with a chr17 abnormality without loss of 17p and in 4.7% of cases with an abnormal karyotype not involving chr17. Our results suggest that applying FISH of 17p13 to identify the number of copies of the TP53 gene could be beneficial in patients with a complex karyotype. We recommend using FISH of 17p13 in young patients with a normal karyotype or non-informative cytogenetics, and always in isolated del(17p

A European consensus report on blood cell identification : terminology utilized and morphological diagnosis concordance among 28 experts from 17 countries within the European LeukemiaNet network WP10, on behalf of the ELN Morphology Faculty

This paper describes the methodology used to develop a consensual glossary for haematopoietic cells within Diagnostics-WP10 of European-LeukemiaNet EU-project. This highly interactive work was made possible through the use of the net, requiring only a single two-day meeting of actual confrontation and debate. It resulted in the production of a freely accessible tool that could be useful for training as well as harmonization of morphological reports in onco-haematology especially, without geographic limitation, not limited to European countries. Moreover, this collective work resulted in the production of a consensus statement, taking into account individual practices, collegial agreement and literature data