Thiele J, Grashof K, Fisher R
Institute of Pathology, University of Cologne, FRG.
Anal Cell Pathol. 1991 Jul;3(4):225-31.
Planimetric analysis of argyrophilic (reticulin) fibers of the bone marrow was performed on 17 patients (7 males, 10 females, median age 52 years) with acute myeloid leukemia (AML). Trephine biopsies were investigated at presentation and during the course of chemotherapy. Density of reticulin was determined by examining the total marrow area as well as the hematopoietic tissue. In about half of the patients with FAB-subtypes M4, M5 an increased amount of fibers was recognizable on admission in comparison with age-matched controls. Two to five bone marrow biopsies (total 81) of each patient were obtained at intervals ranging mostly between three and seven weeks after cytotoxic treatment. The following results could be demonstrated: in several patients with a normal or elevated fiber count at onset, partial and complete remission was characterized by an increase in reticulin in the regenerative hematopoietic tissue. On the other hand, a relapse was most frequently heralded by a reduction of the formerly increased amount of fibers. Because of the inverse relationship between the density of argyrophilic fibers and the amount of fat cells, these findings were observable only by considering the hematopoietic tissue and not the total marrow area, as has been done in previous studies. For this reason a significant decrease in reticulin fibers in the areas of regenerative hematopoiesis may be suggestive of an impending relapse of AML.
对17例急性髓系白血病（AML）患者（7例男性，10例女性，中位年龄52岁）的骨髓嗜银（网状）纤维进行了平面分析。在初诊时和化疗过程中对环钻活检组织进行了研究。通过检查整个骨髓区域以及造血组织来确定网状纤维的密度。与年龄匹配的对照组相比，在大约一半的FAB亚型M4、M5患者中，入院时可识别出纤维数量增加。在细胞毒性治疗后，大多间隔三至七周对每位患者进行两至五次骨髓活检（共81次）。可得出以下结果：在发病时纤维计数正常或升高的几名患者中，部分缓解和完全缓解的特征是再生造血组织中网状纤维增加。另一方面，复发最常见的先兆是先前增加的纤维数量减少。由于嗜银纤维密度与脂肪细胞数量呈反比关系，这些发现只有在考虑造血组织而非整个骨髓区域时才能观察到，而此前的研究是考虑整个骨髓区域。因此，再生造血区域中网状纤维显著减少可能提示AML即将复发。
