Thiele Jürgen, Kvasnicka Hans Michael, Facchetti Fabio, Franco Vito, van der Walt Jon, Orazi Attilio
Institute for Pathology, University of Cologne, Germany.
Haematologica. 2005 Aug;90(8):1128-32.
Quantification of characteristic bone marrow biopsy features includes basic parameters such as cellularity and fiber content. These are important to assess the dynamics of disease processes with a significant impact on risk stratification, survival patterns and, especially, therapy-related changes. A panel of experienced European pathologists and a foreign expert evaluated, at a multi-headed microscope, a large number of representative slides of trephine biopsies from patients with myelofibrosis in an attempt to reach a consensus on how to grade cellularity and fibrosis. This included a critical evaluation of previously described scoring systems. During the microscopic analysis and subsequent discussion and voting, the importance of age-dependent decrease in cellularity was recognized. Grading of myelofibrosis was simplified by using four easily reproducible categories including differentiation between reticulin and collagen. A consensus was reached that the density of fibers must be assessed in relation to the hematopoietic tissue. This feature is especially important in order to avoid a false impression of a reduced fiber content in fatty and/or edematous bone marrow samples after treatment. The consensus for measuring myelofibrosis by clear and reproducible guidelines achieved by our group should allow for precise grading during the disease process and after therapy.
特征性骨髓活检特征的量化包括细胞密度和纤维含量等基本参数。这些对于评估疾病进程的动态变化很重要，对风险分层、生存模式，尤其是与治疗相关的变化有重大影响。一组经验丰富的欧洲病理学家和一位外国专家在多头显微镜下评估了大量骨髓纤维化患者的环钻活检代表性切片，试图就如何对细胞密度和纤维化进行分级达成共识。这包括对先前描述的评分系统进行批判性评估。在显微镜分析以及随后的讨论和投票过程中，认识到了细胞密度随年龄下降的重要性。通过使用四个易于重复的类别简化了骨髓纤维化的分级，包括区分网状纤维和胶原纤维。达成的共识是，必须相对于造血组织评估纤维密度。这一特征尤为重要，以避免在治疗后的脂肪性和/或水肿性骨髓样本中对纤维含量减少产生错误印象。我们小组通过清晰且可重复的指南达成的测量骨髓纤维化的共识，应有助于在疾病过程中和治疗后进行精确分级。
