Significance of bone marrow reticulin fibrosis in chronic lymphocytic leukemia at diagnosis

Autor: Tamar, Tadmor, Lev, Shvidel, Ariel, Aviv, Rosa, Ruchlemer, Osnat, Bairey, Mona, Yuklea, Yair, Herishanu, Andre, Braester, Naomi, Rahimi-Levene, Naomi, Levene, Fiona, Vernea, Jonathan, Ben-Ezra, Jacob, Bejar, Aaron, Polliack
Rok vydání: 2013
Předmět:
Male
Cancer Research
Pathology
Chronic lymphocytic leukemia
Kaplan-Meier Estimate
Severity of Illness Index
Gastroenterology
Leukocyte Count
Bone Marrow
hemic and lymphatic diseases
Odds Ratio
Israel
Coloring Agents
Aged
80 and over
medicine.diagnostic_test
Anemia
Bone Marrow Examination
Middle Aged
Prognosis
Reticulin
Leukemia
medicine.anatomical_structure
Oncology
Female
Adult
Silver Staining
medicine.medical_specialty
Predictive Value of Tests
Internal medicine
medicine
Humans
Myelofibrosis
Survival analysis
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Platelet Count
business.industry
Chromosomes
Human
Pair 11
Cancer
medicine.disease
Leukemia
Lymphocytic
Chronic
B-Cell
Thrombocytopenia
Bone marrow examination
Primary Myelofibrosis
Bone marrow
beta 2-Microglobulin
business
Gene Deletion
Zdroj: Cancer. 119:1853-1859
ISSN: 0008-543X
DOI: 10.1002/cncr.27930
Popis: BACKGROUND: Bone marrow (BM) biopsies from patients with chronic lymphocytic leukemia (CLL) may show reticulin fibrosis at diagnosis, but its significance remains unclear. This study sought to assess the prognostic impact of BM reticulin fibrosis in patients with previously untreated CLL. METHODS: Data was reviewed from untreated CLL patients in the national Israel CLL database, followed during 1987 to 2012. All bone marrow biopsies were graded for reticulin fibrosis using a modified scoring system containing 4 grades (0-3), based on the European consensus report. Grade of reticulin fibrosis was correlated with overall survival (OS), outcome, and a number of well-recognized prognostic factors for CLL. RESULTS: The final cohort included 176 patients (122 males and 51 females). Median age was 63 years (range, 32-86 years) and the 5-year OS was 77.1%. Grade of BM reticulin fibrosis correlated with OS (P < .0001) and mortality (P = .001), and separated patients into 2 groups with different survival curves. Advanced reticulin fibrosis (grades 2-3) was associated with thrombocytopenia (platelet counts of < 100,000/mm3) (P = .025), anemia (P = .018), elevated β2-microglobulin < 4000 μg/mL (P = .048), and the presence of 11q deletion (P = .0015). CONCLUSIONS: There was a significant correlation between poor survival and grade of BM reticulin fibrosis. This staining procedure is easy to perform and can readily be added routinely when examining BM biopsies in CLL, because the findings do have prognostic implications. Cancer 2013. © 2013 American Cancer Society.
Databáze: OpenAIRE
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