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Blood, 1 June 2001, Vol. 97, No. 11, pp. 3665-3667

BRIEF REPORT

Clinical correlates of splenic histopathology and splenic karyotype in myelofibrosis with myeloid metaplasia

Ruben A. Mesa, Chin-Yang Li, Georgene Schroeder, and Ayalew Tefferi

From the Division of Hematology and Internal Medicine, the Division of Hematopathology, and the Cancer Center Statistics Unit, Mayo Clinic, Rochester, MN.

Splenic extramedullary hematopoiesis is an integral component of myelofibrosis with myeloid metaplasia (MMM) and may be classified into 3 distinct histologic patterns of infiltration by myeloid precursors: diffuse, nodular, and a predominance of immature granulocytes. These 3 histologic patterns occurred in 121 (56.8%), 75 (35.2%), and 17 (8%), respectively, of 213 patients with MMM who underwent splenectomy at a single institution. In general, karyotypic findings in splenic tissue (n = 92) were similar to those seen in the bone marrow. The histologic pattern of immature granulocyte predominance, the presence of microscopic splenic infarcts (26 patients), or the detection of an abnormal splenic karyotype (52 patients) was significantly associated with decreased postsplenectomy survival. These adverse features were also associated with characteristics of advanced disease. These observations support the bone marrow origin of the myeloid progenitor pool in the spleen of patients with MMM and suggest a prognostic value for splenic histopathology and karyotype.

© 2001 by The American Society of Hematology.
 

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