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Bone marrow fibrosis in childhood acute lymphoblastic leukemia correlates to biological factors, treatment response and outcome
Dept of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Genetics and Pathology.
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2008 (English)In: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 22, no 3, 504-510 p.Article in journal (Refereed) Published
Abstract [en]

We retrospectively evaluated reticulin fiber density (RFD) in 166 diagnostic bone marrow (BM) biopsies and 62 biopsies obtained at treatment day 29 from children with acute lymphoblastic leukemia (ALL). Patients with B-cell precursor (BCP)-ALL showed higher RFD as compared to patients with T-cell ALL (P<0.001). RFD correlated negatively with white blood cell count (P=0.008) in BCP-ALL patients. Patients with high-hyperdiploid ALL (51-61 chromosomes), no high-risk criteria and low RFD showed a favorable outcome when compared to similar patients with high RFD (P=0.002). In BCP-ALL patients, RFD at diagnosis correlated to the levels of minimal residual disease (MRD) analyzed by flow cytometry on treatment day 29 (P=0.001). Accordingly, patients with MRD > or = 10(-4) presented higher RFD at diagnosis compared to patients with MRD < 10(-4) (P=0.003). BCP-ALL patients with low RFD at diagnosis and a rapid reduction of RFD on day 29 had a favorable outcome compared to patients with the same baseline RFD level at diagnosis but a slow RFD reduction (P=0.041). To our knowledge, these findings are novel and may indicate BM fibrosis as a new valuable prognostic marker in childhood ALL. Expanded use of BM biopsy both at diagnosis and during follow-up is suggested.

Place, publisher, year, edition, pages
2008. Vol. 22, no 3, 504-510 p.
Keyword [en]
acute lymphoblastic leukemia, high-hyperdiploid, childhood, bone marrow fibrosis, MRD, prognosis
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-13141DOI: 10.1038/sj.leu.245072ISI: 000253957500006PubMedID: 18094715OAI: oai:DiVA.org:uu-13141DiVA: diva2:40911
Available from: 2008-01-21 Created: 2008-01-21 Last updated: 2011-02-26Bibliographically approved

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Lönnerholm, Gudmar
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