Fibrosis, Grade 0 does not mean None

[EPguy]

In another thread we've been discussing cellularity and fibrosis. I've found an unexpected (to me) result in my study. None is not an answer, we all need some fibers of fibrosis to support the marrow. The MPN condition starts when "some" becomes "more".

"Structural fibrils constitute a physiological component of the bone marrow stromal microenvironment and contribute to providing a connective tissue structure and a support for hematopoietic progenitor cells. The most common fibers in the bone marrow are reticulin and collagen type I/III"

So everyone needs at least some, even collagen.

onlinelibrary.wiley.com/doi...

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More specifically here is a simple list of each grade, where 0 is normal but explicitly means some:

Table 3. Consensus on the grading of myelofibrosis (MF) as adapted from the literature.32,33,36

Grading Description

MF - 0 Scattered linear reticulin with no intersections (cross-overs) corresponding to normal bone marrow

MF - 1 Loose network of reticulin with many intersections, especially in perivascular areas

MF - 2 Diffuse and dense increase in reticulin with extensive intersections, occasionally with only focal bundles of collagen and/or focal osteosclerosis

MF - 3 Diffuse and dense increase in reticulin with extensive intersections with coarse bundles of collagen, often associated with significant osteosclerosis

In czemp.org/res/file/Thiele-E...

[Cja1956]

Thanks so much for explaining that. It was very interesting. I am post Et Mf intermediate 1 with grade 2 fibrosis. Specifically, my last BMB says “reticulin stain shows grade 2 fibrosis”. The doctors really don’t explain anything to you and some of the medical articles are too difficult for me to understand.

[EPguy in reply to Cja1956]

I agree Drs are rarely good at helping us understand what's in us. This new info won't change any thing we do, but understanding helps our holistic treatments.