PROGNOSTIC-SIGNIFICANCE OF BONE-MARROW RETICULIN FIBERS IN IDIOPATHICMYELOFIBROSIS - EVALUATION OF CLINICOPATHOLOGICAL PARAMETERS IN A SCORING SYSTEM

A clinicopathological scoring system was performed for obtaining a bet ter estimate of prognosis in 50 patients with idiopathic myelofibrosis (IMF). Laboratory parameters including Hb-level, leukocyte and platel et counts, percentage of blast cells in peripheral blood, spleen and l iver size, and a semiquantitative histological grading of reticulin fi bre content of bone marrow biopsies taken at the time of initial diagn osis were analysed. Based upon these haematological and histological p arameters three prognostic groups could be categorized with a signific antly different survival (low-risk group with 21 patients = 75 months; medium-risk group with 18 patients = 51 months, and 11 patients in a high-risk group = 18 months). In an univariate (log rank test) and in a multivariate regression analysis the Hb-concentration, mild splenome galy (less than 5 cm) and a higher grade of bone marrow reticulin cont ent proved to be important prognostic parameters, whilst leukopenia, t hrombocytopenia and the presence of peripheral blast cells were only o f prognostic significance within the first 6 months from initial diagn osis. It was concluded that the increase of reticulin fibre deposition in bone marrow together with anaemia and mild splenomegaly could be r esponsible for a progressively worse life-expectancy of high-risk pati ents with idiopathic myelofibrosis.