Significance of bone marrow fibrosis in multiple myeloma

Subramanian, Rajiv; Basu, Debdatta; Dutta, Tarun Kumar

doi:10.1080/00313020701570038

Cited by 28 publications

(25 citation statements)

References 9 publications

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“…3 In multiple myeloma, increase of bone marrow fibrosis correlates with poorly differentiated plasma cell morphology and mitotic activity and is associated with reduced median survival time. 4 The grading of bone marrow fibrosis has been reported to have a prognostic significance in primary myelofibrosis, 5,6 and in a recent study, we have confirmed these data. 7 Finally, a distinct subgroup of patients with myelodysplastic syndrome has bone marrow fibrosis and this finding is associated with high transfusion requirements and poor prognosis.…”

supporting

confidence: 87%

The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis

et al. 2012

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supporting

confidence: 87%

The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis

et al. 2012

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“…Subramanian et al had observed that increased fibrosis correlated significantly with the plasma cell morphology and mitotic activity of plasma cells and these patients had a median survival time of just 11 months. [18] The criterion for the plasma cell differentiation we used was the same as that proposed by Sailer et al [7] Poorly differentiated myeloma [plasmablastic myeloma] is known to have poor prognosis. [1,5,7] When the morphology of the plasma cells was compared with the clinical stage of the disease it was seen to be statistically significant (P = 0.037).…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of bone marrow histology in multiple myeloma

Subramanian

Basu

2009

Indian J Cancer

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BACKGROUND: Bone marrow examination continues to be the cornerstone for establishing the diagnosis of multiple myeloma in association with other clinical and laboratory parameters. Plasma cell morphology has signifi cant correlation with clinical stage and survival. AIMS: To note the bone marrow histology in detail in multiple myeloma and to correlate it with clinical stage and survival. METHODS AND MATERIAL: Fifty-fi ve cases of multiple myeloma diagnosed between January 2001 and December 2006, who had a bone marrow aspiration and biopsy done at the time of diagnosis were included in the present study. STATISTICAL ANALYSIS: SPSS software version 13.0 was used. Clinical stage and plasma cell morphology were correlated using chi square test and Spearman's correlation coeffi cient. Survival analysis was done using the Kaplan-Meier method. RESULTS: Seventy-six percent patients were in clinical stage III, 17% and 7% were in stage II and I respectively. The clinical stage correlated signifi cantly with plasma cell morphology, percentage of plasma cell infi ltration and pattern of infi ltration. Plasma cell morphology correlated signifi cantly with bone marrow parameters like percentage infi ltrate, pattern of infi ltration, degree of fi brosis and mitotic activity. Patients in advanced clinical stage, >50% plasma cells in the marrow, diffuse pattern of infi ltration, high mitosis and increased fi brosis had a shorter median survival than patients with favorable features. CONCLUSIONS: It is recommended that the bone marrow histology be studied in detail in multiple myeloma at diagnosis since it correlates well with the clinical stage and offers useful prognostic information.

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“…BM fibrosis adversely affects therapeutic efficacy and outcome in patients with chronic myelogenous leukemia and plasma cell myeloma. [1,2] In primary myelofibrosis (PMF), collagenous BM fibrosis has been reported to predict an adverse outcome [3–5] even within the poor risk patient group defined by the International Prognostic Scoring System (IPSS). [6] In myelodysplastic syndromes (MDS), the clinical relevance of BM fibrosis was not well recognized in the past and this histological feature was not incorporated into the 2008 World Health Organization (WHO) classification.…”

Section: Introductionmentioning

confidence: 99%

The clinical importance of moderate/severe bone marrow fibrosis in patients with therapy-related myelodysplastic syndromes

Goswami

et al. 2013

Ann Hematol

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Background The presence of moderate to severe bone marrow (BM) fibrosis has been shown to be an adverse feature in patients with primary myelodysplastic syndromes (MDS). However, the clinical importance of BM fibrosis is not clear in therapy-related MDS. Methods We retrieved all t-MDS cases (n=266) diagnosed at our hospital over a 10-year period (2003–2012). Reticulin and trichromestains were performed in cases in which BM fibrosis was suspected on initial evaluation of hematoxylin & eosin stained slide. BM fibrosis was graded according to European consensus guidelines, and a score of MF2/MF3 was defined as moderate/severe fibrosis. Result Moderate/severe BM fibrosis was found in 47 (17%) patients. Compared to 219 patients with no/mild BM fibrosis, the patients with moderate/severe fibrosis presented with severer thrombocytopenia (p=0.039), higher numbers of circulating blasts (p=0.051) but similar degrees of anemia and neutropenia, transfusion requirements, and similar incidences of hepatosplenomegaly and constitutional symptoms. Histological examination revealed a comparable BM cellularity and BM blast percentage, but markedly increased megakaryocytes (p<0.001) in the fibrotic group. Although the risk distribution of cytogenetic data was similar according to the New Comprehensive Cytogenetic Scoring criteria, −5 and −17 were more frequently observed in t-MDS with moderate/severe BM fibrosis (p=0.031 and p=0.043 respectively). With a median follow-up of 11.5 months, patients with moderate/severe BM fibrosis showed a similar risk of acute myeloid leukemia transformation, and a comparable overall survival in univariate and multivariate analyses. Conclusions Moderate/severe BM fibrosis in patients with t-MDS is associated with certain clinicopathological and genetic features. However, unlike the situation in patients with primary MDS, moderate/severe BM fibrosis does not add additional risk to patients with therapy-related MDS.

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Significance of bone marrow fibrosis in multiple myeloma

Cited by 28 publications

References 9 publications

The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis

The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis

Prognostic significance of bone marrow histology in multiple myeloma

The clinical importance of moderate/severe bone marrow fibrosis in patients with therapy-related myelodysplastic syndromes

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