Birjees Mazhar Kazi, Masood Anwar, Muhammad Saleem, Amir Hussain Khan.
The frequency and the severity of myelofibrosis in various haematological disorders.
Pak J Pathol Jan ;9(2):25-31.

A total of 160 bone marrow trephine biopsies in various haematological disorders were studied. Of these 94 cases (58.75%) showed fibrosis of varying grades, while 66 cases (41.25%) showed no bone marrow fibrosis. The majority i.e. 87 (92.5%) of these 94 cases were of secondary myelofibrosis. Primary idiopathic myelofibrosis (IMF) was diagnosed only in 7 cases (7.45%). The severity of fibrosis also varied in different disorders. Grade-1 fibrosis was seen in 33 cases (35.21 %), Grade-2 in 27 cases (28.62%), Grade-3 in 23 cases (24.47%) and Grade-4 in 11 cases (11.70%). The grading was done on the basis of a carefully evolved new semiquantitative grading system for fibrous tissue content evaluation. With the help of this new evaluation system benign disorders e.g. anaemias causing erythroid hyperplasia and infections causing myeloid hyperplasia were conspicuous by absence of fibrosis. Among malignant disorders lymphoid malignancies and myeloproliferative disorders were associated with more severe grades of fibrosis. Astonishingly two out of three cases of myelodysplastic syndrome showed grade-4 fibrosis.

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