Publication: Standardization of bone marrow features - does it work in hematopathology for
histological discrimination of different disease patterns?
Authors
Thiele, J. ; Kvasnicka, H.M. ; Diehl, V.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Standardized bone marrow (BM) features
determined by semiquantitative scoring are valuable
tools for the recognition and easily reproducible
interpretation of histological patterns in
hematopathology. This procedure may help to
characterize various disease entities, but especially to
differentiate chronic myeloproliferative disorders
(MPDs) with increased platelet counts from reactive
thrombocytosis (RTh). A clear-cut separation of these
conditions continues to present a major problem in
hematology. Therefore MPDs are a most suitable model
to test the diagnostic relevance of this procedure. By
regarding the literature and based on archive material
that involved BM biopsies of 319 patients, a
semiquantitative grading of histological parameters was
performed. Standardized features were applied for a
stepwise discriminant analysis to establish different sets
of variables exerting a diagnostic impact. A distinction
into five histological patterns was achieved that showed
a correctly predicted group membership of about 94 %.
These were consistent with the clinicopathological
diagnosis of polycythemia vera, essential
thrombocythemia (ET), prefibrotic or early fibrotic
chronic idiopathic myelofibrosis (CIMF) and finally
RTh. Variables of discriminating potency according to
their ranking included megakaryopoiesis (maturation
defects, nuclear lobulation, naked and bulbous nuclei,
small and giant size), reticulin fibers, erythro- and
granulopoiesis (left shifting and quantity) and cellularity.
These findings are in keeping with the assumption that
characteristic patterns of BM histopathology can be
assigned to different subtypes of MDPs mimicking ET.
Discrimination between ET and especially early stage
CIMF with thrombocythemia is warranted because of
significant implications concerning therapeutic
strategies, follow-up examinations and survival. Regarding these results, a schematic procedure is
proposed to be used for daily routine diagnosis
concerning the discrimination of MPDs.
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