Grade of bone marrow fibrosis is associated with relevant hematological findings—a clinicopathological study on 865 patients with chronic idiopathic myelofibrosis

摘要: Controversy continues to exist regarding not only the exact definition and grading of myelofibrosis (MF), but also whether, what extent, this feature may be correlated with clinical findings. A retrospective study was performed involving 865 bone marrow (BM) biopsies together records from patients chronic idiopathic (CIMF). Diagnosis established according World Health Organization criteria, assessment MF followed a consensus scoring system that included four grades (MF-0 MF-3). Histopathological evaluations were carried out in an independent fashion. Prefibrotic early CIMF (MF-0/-1) presented by 565 showing borderline mild anemia no or slight splenomegaly, frequently, thrombocytosis exceeding 500x10(9)/l shown. In 300 patients, manifest reticulin collagen fibrosis (MF-2/-3) characterized marked anemia, gross peripheral blasts, normal decreased platelet leukocyte counts. The latter cohort consistent findings generally keeping myeloid metaplasia. Regarding stepwise evolution disease, sequential BM examinations showed 103 prefibrotic transformed into advanced stages accompanied correspondingly developing histomorphological features. Survival analysis (univariate calculation) revealed significantly more favorable prognosis vs CIMF. On other hand, higher classes exerted risk profile (Lille score). conclusion, dynamics disease process are evolving closely associated changes relevant hematological