Reproducibility of the WHO histological criteria for the diagnosis of Philadelphia chromosome-negative myeloproliferative neoplasms

Umberto Gianelli, Anna Bossi, Ivan Cortinovis, Elena Sabattini, Claudio Tripodo, Emanuela Boveri, Alessia Moro, Riccardo Valli, Maurilio Ponzoni, Ada M Florena, Giulio F Orcioni, Stefano Ascani, Emanuela Bonoldi, Alessandra Iurlo, Luigi Gugliotta, Vito Franco

Research output: Contribution to journalArticlepeer-review


This study, performed on behalf of the Italian Registry of Thrombocythaemias (Registro Italiano Trombocitemie), aimed to test the inter-observer reproducibility of the histological parameters proposed by the WHO classification for the diagnosis of the Philadelphia chromosome-negative myeloproliferative neoplasms. A series of 103 bone marrow biopsy samples of Philadelphia chromosome-negative myeloproliferative neoplasms consecutively collected in 2004 were classified according to the WHO criteria as follows: essential thrombocythaemia (n=34), primary myelofibrosis (n=44) and polycythaemia vera (n=25). Two independent groups of pathologists reviewed the bone marrow biopsies. The first group was asked to reach a collegial 'consensus' diagnosis. The second group reviewed individually all the cases to recognize the main morphological parameters indicated by the WHO classification and report their results in a database. They were subsequently instructed to individually build a 'personal' diagnosis of myeloproliferative neoplasms subtype just assembling the parameters collected in the database. Our results indicate that high levels of agreement (≥70%) have been reached for about all of the morphological features. Moreover, among the 18 evaluated histological features, 11 resulted statistically more useful for the differential diagnosis among the different Philadelphia chromosome-negative myeloproliferative neoplasms. Finally, we found a high percentage of agreement (76%) between the 'personal' and 'consensus' diagnosis (Cohen's kappa statistic >0.40). In conclusion, our results support the use of the histological criteria proposed by the WHO classification for the Philadelphia chromosome-negative myeloproliferative neoplasms to ensure a more precise and early diagnosis for these patients.

Original languageEnglish
Pages (from-to)814-822
Number of pages9
JournalModern Pathology
Issue number6
Publication statusPublished - 2014


  • essential thrombocythaemia
  • myeloproliferative neoplasms
  • polycythaemia vera
  • primary myelofibrosis
  • WHO classification

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medicine(all)


Dive into the research topics of 'Reproducibility of the WHO histological criteria for the diagnosis of Philadelphia chromosome-negative myeloproliferative neoplasms'. Together they form a unique fingerprint.

Cite this