Tadmor et al evaluated patients with chronic lymphocytic leukemia based on the extent of fibrosis seen in the bone marrow biopsy at the time of diagnosis. The authors are from multiple hospitals in Israel.
Patient selection: CLL
Bone marrow fibrosis was graded as mild/early (Grade 0 or 1) and advanced/diffuse/dense (Grade 2 or 3).
Fibrosis on a Reticulin Stain
Grade
scattered linear reticulin fibers without intersections
0
loose network of reticulin fibers
1
diffuse reticulin fibers with intersections
2
dense reticulin fibrosis with extensive intersections
3
Prognostic factors from multivariate analysis:
(1) Binet stage C
(2) advanced fibrosis
A patient with advanced bone marrow fibrosis tended to have:
(1) thrombocytopenia (platelet count < 100,000 per µL)
(2) anemia
(3) elevated concentration of beta-2 microglobulin (> 1.5 times the upper limit of normal)
(4) presence of the 11q deletion and possibly 17p deletion
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