Volume 44, Issue 3 pp. 531-537
ORIGINAL ARTICLE

The value of next-generation sequencing in routine diagnostics and management of patients with cytopenia

Marie Fredslund Breinholt

Corresponding Author

Marie Fredslund Breinholt

Department of Pathology, Herlev og Gentofte Hospital, Herlev, Denmark

Correspondence

Marie Fredslund Breinholt, Department of Pathology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 73, DK-2730 Herlev, Denmark.

Email: [email protected]

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Kåre Nielsen

Kåre Nielsen

Department of Pathology, Zealand University Hospital, Roskilde, Denmark

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Lone Schejbel

Lone Schejbel

Department of Pathology, Herlev og Gentofte Hospital, Herlev, Denmark

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Daniel El Fassi

Daniel El Fassi

Department of Hematology, Herlev og Gentofte Hospital, Herlev, Denmark

Department of Hematology, Rigshospitalet, Copenhagen, Denmark

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

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Claudia Schöllkopf

Claudia Schöllkopf

Department of Hematology, Herlev og Gentofte Hospital, Herlev, Denmark

Department of Hematology, Rigshospitalet, Copenhagen, Denmark

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Guy Wayne Novotny

Guy Wayne Novotny

Department of Pathology, Herlev og Gentofte Hospital, Herlev, Denmark

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Bo Kok Mortensen

Bo Kok Mortensen

Department of Hematology, Herlev og Gentofte Hospital, Herlev, Denmark

Department of Hematology, Rigshospitalet, Copenhagen, Denmark

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Azhar Ahmad

Azhar Ahmad

Department of Hematology, Herlev og Gentofte Hospital, Herlev, Denmark

Department of Hematology, Rigshospitalet, Copenhagen, Denmark

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Estrid Høgdall

Estrid Høgdall

Department of Pathology, Herlev og Gentofte Hospital, Herlev, Denmark

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Peter Nørgaard

Peter Nørgaard

Department of Pathology, Herlev og Gentofte Hospital, Herlev, Denmark

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First published: 10 February 2022
Citations: 1

Marie Fredslund Breinholt and Kåre Nielsen are Co-first authors.

Funding information

None.

Abstract

Introduction

We performed a single-center study of real-world health data to investigate the direct clinical consequence of targeted next-generation sequencing (NGS) results integrated in the clinicopathological evaluation of patients with cytopenia suspected of myelodysplastic syndrome (MDS).

Methods

The study included 87 newly referred patients, who had a bone marrow examination, which included targeted NGS analysis. NGS was requested at the discretion of either examining pathologist or hematologist. Data were collected retrospectively from patient files including pathology reports with integrated NGS results.

Results

The NGS results had a diagnostic impact in 67 cases (77%) when combining both histopathological and final clinical evaluation and provided prognostic value in 19 cases (22%). NGS supported a confident or tentative histopathological diagnosis in 52 cases (60%). Twenty cases (23%) had a final diagnosis of either Clonal Cytopenia of Undetermined Significance (CCUS) or Idiopathic Cytopenia of Undetermined Significance (ICUS). In 4 cases, NGS results affected the choice of principal treatment strategy, including considerations of allotransplantation. Twenty-one patients (24%) could be discharged to primary care physician.

Conclusion

In a multidisciplinary clinicopathological real-world setting, NGS analysis of bone marrow samples from selected patients contributed substantially to the diagnostic evaluation and management of patients with cytopenia suspected of MDS. Consequently, we have now included NGS analysis in most routine bone marrow examinations from patients with MDS or unexplained cytopenia.

CONFLICT OF INTEREST

The authors have no competing interests.

DATA AVAILABILITY STATEMENT

The data presented in this article are not readily available in compliance with Danish Law and the General Data Protection Rules.

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