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Chronic Myeloid Leukaemia

Relevance and dynamics of myelofibrosis regarding hematopoietic reconstitution after allogeneic bone marrow transplantation in chronic myelogenous leukemia – a single center experience on 160 patients

Bone Marrow Transplantation volume 26, pages 275–281 (2000)Cite this article

Abstract

A retrospective single center study was performed on 516 trephine biopsies derived from 160 patients with stable phase Ph+-CML and allogeneic BMT. Following morphometric quantification of reticulin-collagen fibers we tried to elucidate (1) the dynamics of bone marrow fibrosis in the post-transplant period; and (2) the influence of manifest myelofibrosis on relevant engraftment parameters. An evaluation of fiber density at standardized endpoints after BMT was carried out on a selected cohort of 124 patients (399 biopsy specimens). A manifest myelofibrosis (more than a three-fold increase compared to the normal fiber content) before BMT was found in 26% of our patients. Concentrating on bone marrow areas with reconstituting hematopoiesis, several findings emerged. Pretransplant myelofibrosis was associated with an initial regression following BMT, but insidiously recurred in the areas of regenerating hematopoiesis or developed in a few patients without increased pregraft fibers during the post-transplant period (mean observation time more than 4 months). Severe acute GVHD (grades III and IV) was significantly correlated with a greater amount of reticulin fibers in the early post-transplant period (9 to 30 days after BMT). Regarding engraftment parameters, a significant delay was detectable in the time to achieve transfusion independence for the patients with manifest myelofibrosis compared to those without pretransplant fiber increase. Bone Marrow Transplantation (2000) 26, 275–281.

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Acknowledgements

The authors are greatly indebted to Mrs B Rosenbach, Mrs M Wonschick and Mrs H Tilemann for their excellent technical assistance. This work was supported by a grant from the Dr M Scheel Foundation for Cancer Research (70–2134-ThI).

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Authors and Affiliations

  1. Institute of Pathology, University of Cologne, Germany

    J Thiele, HM Kvasnicka, TK Zirbes, F Jung & D Reske

  2. Institute of Pathology, University of Essen, Germany

    LD Leder

  3. Department of Bone Marrow Transplantation, Institute of Pathology, University of Essen, Essen, Germany

    DW Beelen & UW Schaefer

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Thiele, J., Kvasnicka, H., Beelen, D. et al. Relevance and dynamics of myelofibrosis regarding hematopoietic reconstitution after allogeneic bone marrow transplantation in chronic myelogenous leukemia – a single center experience on 160 patients. Bone Marrow Transplant 26, 275–281 (2000). https://doi.org/10.1038/sj.bmt.1702505

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