{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:52:30Z","timestamp":1777899150885,"version":"3.51.4"},"reference-count":7,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Cancer Center Support Grant","award":["NCI Grant P30 CA016672"],"award-info":[{"award-number":["NCI Grant P30 CA016672"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Enumeration of blasts and promonocytes is essential for World Health Organization (WHO) classification of myelomonocytic neoplasms. The accuracy of distinguishing blasts, promonocytes and monocytes, including normal vs abnormal monocytes, remains controversial. The objective of this analysis is to assess concordances between experienced hematopathologists in classifying cells as blasts, promonocytes, and monocytes according to WHO criteria. Each of 11 hematopathologists assessed glass slides from 20 patients [12 with chronic myelomonocytic leukemia (CMML) and 8 with acute myeloid leukemia (AML)] including blood and BM aspirate smears, and limited nonspecific esterase (NSE) stains. All cases were blindly reviewed. Fleiss\u2019 extension of Cohen's kappa for multiple raters was used on these variables, separately for peripheral blood (PB) and bone marrow (BM). Spearman's rank correlation was used to assess correlations between each pair of hematopathologists for each measurement. For the classification based on the sum of blasts and promonocytes in the BM, Fleiss\u2019 kappa was estimated as 0.744. For PB, categorizing patients according to the sum of blasts and promonocytes, Fleiss\u2019 kappa was estimated as 0.949. Distinction of abnormal monocytes from normal monocytes in PB did not achieve a good concordance and showed strong evidence of differences between hematopathologists (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). The hematopathologists achieved a good concordance rate of 74% in CMML vs AML classification and a high k rate, confirming that criteria for defining the blasts equivalents (blasts plus promonocytes) could be applied consistently. Identification of monocyte subtypes (abnormal vs normal) was not concordant. Our results support the practice of combining blasts\/promonocytes into a single category.<\/jats:p>","DOI":"10.1111\/ijlh.13212","type":"journal-article","created":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T07:30:44Z","timestamp":1587022244000},"page":"418-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Concordance among hematopathologists in classifying blasts plus promonocytes: A bone marrow pathology group study"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5143-4835","authenticated-orcid":false,"given":"Kathryn","family":"Foucar","sequence":"first","affiliation":[{"name":"Department of Pathology University of New Mexico Albuquerque New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8623-4067","authenticated-orcid":false,"given":"Eric D.","family":"Hsi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sa A.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematopathology University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8491-224X","authenticated-orcid":false,"given":"Heesun J.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P.","family":"Hasserjian","sequence":"additional","affiliation":[{"name":"Department of Pathology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Bagg","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-7847","authenticated-orcid":false,"given":"Tracy I.","family":"George","sequence":"additional","affiliation":[{"name":"Department of Pathology University of New Mexico Albuquerque New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Roland L.","family":"Bassett","sequence":"additional","affiliation":[{"name":"Department of Hematopathology University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LoAnn C.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"II","given":"William G.","family":"Morice","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Arber","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attilio","family":"Orazi","sequence":"additional","affiliation":[{"name":"Department of Pathology Texas Tech University El Paso Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos E.","family":"Bueso\u2010Ramos","sequence":"additional","affiliation":[{"name":"Department of Hematopathology University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Bone Marrow Pathology Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"82","volume-title":"WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues","author":"Orazi A","year":"2017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-019-0215-y"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544"},{"key":"e_1_2_7_5_1","first-page":"16","volume-title":"WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues","author":"Arber DA","year":"2017"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.222059"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2008.005421"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12776"}],"container-title":["International Journal of Laboratory 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