Kreft et al identified factors associated with progression of marrow fibrosis in a patient in the pre-fibrotic phase of chronic idiopathic myelofibrosis. These can help identify a patient who may require more aggressive management. The authors are from Medizinische Hochschule in Hannover, Germany.
Parameters:
(1) age of the patient in years
(2) grade of megakaryocytic proliferation (release of growth factors from megakaryocytes one possible cause for fibroblastic proliferation)
Megakaryocytic Proliferation
Grade
normal (no proliferation)
0
slight proliferation
1
moderate proliferation, with or without clusters
2
marked proliferation, with or without sheets
3
Parameter
Finding
Points
age in years
< 60 years
0
>= 60 years
1
grade of megakaryocytic proliferation
0 or 1
0
2 or 3
1
total score =
= SUM(points for both parameters)
Interpretation:
• minimum score: 0
• maximum score: 2
Total Score
Median Period with Grade 0 or 1 Myelofibrosis
0
138 months
1 or 2
58-60 months
where:
• Grade 0 or 1 myelofibrosis indicates no or slight increase in reticulin fibers.
• Grade 2 or 3 myelofibrosis showed increasing amounts of reticulin with or without collagen fibers resulting in a decrease in the space available for blood forming cells.
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