Navigating the 2022 International Consensus and World Health Organization Classifications of Hematopathology: A Call for Unified Diagnostic Language.

Abstract

In 2022, 2 distinct guidelines for the diagnosis of myeloid neoplasms became available: the 5th edition of the World Health Organization guideline (WHO2022) solely and the International Consensus Classification (ICC). Despite major overlap, there are important differences that can have important implications. To explore the current opinions and diagnostic practices of hemato-oncologists and hematopathologists across the United States. An online anonymous survey was created using REDCap, and a secure link was shared via email to fellowship program leadership and via posts on social media. A total of 310 responses were obtained. Only 33 of 309 respondents (10.7%) reported using solely the 2016 World Health Organization guideline to make diagnoses, whereas 167 of 309 (54%) supplemented it with other guidelines. The rest were either not sure (17; 5.5%), used WHO2022 solely (46; 14.9%), or used ICC solely (6; 1.9%). The choice of guideline was not related to region (P = .15), practice setting (P = .86), or hospital size (P = .22). More than 90% reported having 2 distinct guidelines is a source of confusion in clinical diagnosis, management, trial design, and other areas. Overall, our study found that having 2 distinct guidelines could be a source of confusion for physicians and it highlights the need for a unified diagnostic language.