Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Equivalence of BCSH and WHO diagnostic criteria for ET

Leukemia volume 31, pages 527–528 (2017)Cite this article

Subjects

A Corrigendum to this article was published on 05 May 2017

To the editor,

We read with interest the paper from Gisslinger et al.1 who re-examined a group of patients and applied the World Health Organisation (WHO) and British Committee for Standards in Haematology (BCSH) diagnostic criteria for essential thrombocythemia (ET) and evaluated clinical outcomes. They conclude that BCSH defined ET patients (BCSH ET) had worse fibrosis-free survival and prognosis than WHO defined ET (WHO ET), resulting in ‘inappropriate clinical management’. We find these conclusions misleading and wish to highlight to readers of Leukemia a number of problems that raise concerns about the validity of this paper. First and foremost, the analysis is based upon a fundamental failure to correctly apply the BCSH criteria in full. Second, the paper contains multiple factual inaccuracies, methodological deficiencies and consistently fails to provide balanced data interpretation. Finally, the conclusion that BCSH ET ‘displayed a heterogeneous population’, with the implication that WHO ET is more homogeneous, is highly misleading on both molecular and clinical grounds. In the interests of providing a balanced viewpoint, so that readers of Leukemia can draw their own conclusions, we tackle these points in detail below.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Gisslinger H, Jeryczynski G, Gisslinger B, Wolfler A, Burgstaller S, Buxhofer-Ausch V et al. Clinical impact of bone marrow morphology for the diagnosis of essential thrombocythemia: comparison between the BCSH and the WHO criteria. Leukemia 2016; 30: 1126–1132.

    Article  CAS  Google Scholar 

  2. Harrison CN, Bareford D, Butt N, Campbell P, Conneally E, Drummond M et al. Guideline for investigation and management of adults and children presenting with a thrombocytosis. Br J Haematol 2010; 149: 352–375.

    Article  CAS  Google Scholar 

  3. Harrison CN, Butt N, Campbell P, Conneally E, Drummond M, Green AR et al. Modification of British Committee for standards in haematology diagnostic criteria for essential thrombocythaemia. Br J Haematol 2014; 167: 421–423.

    Article  Google Scholar 

  4. Wilkins BS, Erber WN, Bareford D, Buck G, Wheatley K, East CL et al. Bone marrow pathology in essential thrombocythemia: interobserver reliability and utility for identifying disease subtypes. Blood 2008; 111: 60–70.

    Article  CAS  Google Scholar 

  5. Thiele J, Kvasnicka HM, Mullauer L, Buxhofer-Ausch V, Gisslinger B, Gisslinger H . Essential thrombocythemia versus early primary myelofibrosis: a multicenter study to validate the WHO classification. Blood 2011; 117: 5710–5718.

    Article  CAS  Google Scholar 

  6. Buhr T, Hebeda K, Kaloutsi V, Porwit A, Van der Walt J, Kreipe H . European Bone Marrow Working Group trial on reproducibility of World Health Organization criteria to discriminate essential thrombocythemia from prefibrotic primary myelofibrosis. Haematologica 2012; 97: 360–365.

    Article  Google Scholar 

  7. Beer PA, Erber WN, Campbell PJ, Green AR . How I treat essential thrombocythemia. Blood 2011; 117: 1472–1482.

    Article  CAS  Google Scholar 

  8. Madelung AB, Bondo H, Stamp I, Loevgreen P, Nielsen SL, Falensteen A et al. World Health Organization-defined classification of myeloproliferative neoplasms: morphological reproducibility and clinical correlations–-the Danish experience. Am J Hematol 2013; 88: 1012–1016.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Haematology, Guy’s and St Thomas, Hospitals’ NHS Foundation Trust, London, UK

    C N Harrison

  2. Department of Haematology, Queen’s University, Belfast, UK

    M F McMullin

  3. Department of Haematology, University of Cambridge, Cambridge, UK

    A R Green

  4. Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK

    A J Mead

Authors
  1. C N Harrison
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M F McMullin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A R Green
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A J Mead
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C N Harrison.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Correspondences on ‘Clinical impact of bone marrow morphology for the diagnosis of essential thrombocythemia: comparison between the BCSH and the WHO criteria.’ By Gisslinger et al.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Harrison, C., McMullin, M., Green, A. et al. Equivalence of BCSH and WHO diagnostic criteria for ET. Leukemia 31, 527–528 (2017). https://doi.org/10.1038/leu.2016.318

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/leu.2016.318

Search

Advanced search

Quick links