Diagnosis and quantification of bone marrow fibrosis are significantly biased by the pre‐staining processing of bone marrow biopsies

Buesche, Guntram; Georgii, A.; Hh, Kreipe

doi:10.1111/j.1365-2559.2005.02302.x

Cited by 10 publications

(8 citation statements)

References 26 publications

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“…Considering the strong dependence of the diagnosis of MF on the technical preparation of BMBs 39 and on the approach used to prove MF, 23 the diversity in the reported frequencies appears to reflect technical problems or problems of selection rather than a biological difference. Founding the evaluations on patients whose bone marrow had been planned up-front to be both aspirated and biopsied for initial diagnosis of an unclear cytopenia, it is unlikely that full-blown MF affects more than 30% of patients with primary MDS, an observation which is in agreement with earlier results from other authors.…”

Section: Mds With Mfmentioning

confidence: 99%

Marrow fibrosis predicts early fatal marrow failure in patients with myelodysplastic syndromes

et al. 2007

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Section: Mds With Mfmentioning

confidence: 99%

Marrow fibrosis predicts early fatal marrow failure in patients with myelodysplastic syndromes

et al. 2007

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“…9 According to our observations, this method appears to be superior to all other currently known approaches to prove and quantify MF considering sensitivity, specificity, precision, reproducibility, prognostic relevance of results 9 and adjustability to influences from technical processing of BMBs. 29 A ratio V MF o0.05 is equivalent to the fiber content in normal healthy marrow. A ratio between 0.05 and 0.15 indicates FFI, and a ratio V MF 40.15 corresponds to MF in semiquantitative grading.…”

Section: Evaluation Of Marrow Fibrosismentioning

confidence: 99%

Marrow fibrosis and its relevance during imatinib treatment of chronic myeloid leukemia

et al. 2007

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In chronic myeloid leukemia (CML), imatinib may reverse bone marrow fibrosis (MF). Whether the unfavorable prognosis of MF is also reversed and whether imatinib guarantees against evolution of MF are unclear as yet. Fifty-nine patients with Ph þ CML treated with X400 mg imatinib/day were examined for MF in 6-to 12-month intervals. Imatinib effectively reversed initial MF (Po0.0005). However, during a follow-up period of up to 4.8 years, small foci with abnormal fiber increase (FFI) emerged in 8 of 30 pretreated and 6 of 29 non-pretreated patients. Patients with FFI showed a significantly lower probability of achieving a complete cytogenetic or major molecular response (36 versus 81%; Po0.007). During the further follow up, 57% of patients with FFI but none of the other patients suffered from full-blown MF (P ¼ 0.00005). None of the patients with FFI or MF showed a Janus kinase-2 mutation (V617F). Evolutions of FFI and MF were independent significant predictors of imatinib failure (P ¼ 0.0031), accelerated phase and death of patients (P ¼ 0.0001; multivariate analyses). Imatinib effectively reverses initial MF in CML, but neither eliminates its unfavorable prognosis nor guarantees completely against new evolution of MF.

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“…and those derived histologically for the pig calcaneus seem negligible and may be the result of histological preparation rather than the potential inaccuracies of our automated technique. This discrepancy could probably have been reduced, or even eliminated, if the tissue had not been decalcified (Buesche et al, 2006). Hence, while the discrepancies can be explained and do not invalidate the program presented here, more fundamental issues are raised by the present findings, especially when histological sections are used as the gold standard.…”

Section: Discussionmentioning

confidence: 60%

Automated method to measure trabecular thickness from microcomputed tomographic scans and its application

et al. 2006

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Trabeculae form the internal bony mesh work and provide strength to the bone; interconnectivity, overall density, and trabecular thickness are important measures of the integrity of the internal architecture. Such strength is achieved only gradually during ontogeny, whereby an increase in trabecular thickness precedes an increase in mineralization. Loss of bone mass later in life may be compensated for by thickening of the remaining trabeculae. These facts, and the role of trabeculae in mineral homeostasis, highlight the importance of investigating trabecular thickness within and between species. While nondestructive imaging techniques (i.e., mCT and MRI) are becoming increasingly popular, quantification of trabecular thickness using nondestructive techniques has proved difficult owing to limitations imposed by scanning parameters, uniform thresholding, and partial volume averaging. Here we present a computer application, which aims to overcome these problems. Validation is carried out against a phantom and against trabecular thickness measured in corresponding histological sections. Good agreement was found between these measurements. Furthermore, when trabecular thickness is recorded for modern human fetal ilia, a trend toward trabecular thickness increase is found and is in line with reports of ontogenetic morphometric changes using histological sections. However, there are discrepancies. These may in part be due to partial volume effects of obliquely oriented structures. More crucial, however, are problems inherent in histological sections, e.g., shrinkage and distortion, especially where differences in mineralization are concerned; this may affect biological interpretations. Anat Rec Part A, 288A: 982-988, 2006.2006 Wiley-Liss, Inc.

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Diagnosis and quantification of bone marrow fibrosis are significantly biased by the pre‐staining processing of bone marrow biopsies

Abstract: Evaluations of MF and its prognostic significance should consider the bias due to the prestaining processing of BMBs and the necessity of an adjustment to the thickness of tissue sections and the degree of marrow tissue shrinkage.

Cited by 10 publications

References 26 publications

Marrow fibrosis predicts early fatal marrow failure in patients with myelodysplastic syndromes

Marrow fibrosis predicts early fatal marrow failure in patients with myelodysplastic syndromes

Marrow fibrosis and its relevance during imatinib treatment of chronic myeloid leukemia

Automated method to measure trabecular thickness from microcomputed tomographic scans and its application

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