Bone marrow fibrosis in childhood acute lymphoblastic leukemia correlates to biological factors, treatment response and outcome

High modal number and triple trisomies are highly correlated favorable factors in childhood B-cell precursor high hyperdiploid acute lymphoblastic leukemia treated according to the NOPHO ALL 1992/2000 protocols

“…However, only a few clinical features have been shown to be associated with decreased EFS within the HeH group, namely age >10 years, male gender, and bone marrow fibrosis. 5,8,9 As regards genetic factors, it has been suggested that some karyotypic patterns and aberrations -low modal chromosome number, lack of certain trisomies, and the presence of various structural changes -confer a more dismal outcome, albeit with conflicting results in different studies. 2,4,5,7,[9][10][11][12][13] The prognostic impact of the "triple trisomies", i.e., concur-…”

Bone marrow fibrosis and vascular density lack prognostic significance in childhood acute lymphoblastic leukaemia

“…2 The seemingly contradictory findings regarding their prognostic significance most likely reflect a weak or indirect effect on outcome compared with direct measures of response to therapy, such as MRD. If anything, higher RFD was more likely to be associated with better conventional risk factors, such as lower initial white blood cell count, precursor B-rather than T-cell phenotype and hyperploidy.…”

“…Three recent papers by Norén-Nyström et al [1][2][3] have collectively shown that higher levels of bone marrow fibrosis (measured as reticulin fibrin density (RFD)) and increased vascularity (microvessel density (MVD)) are associated with both relapse and higher minimal residual disease (MRD) in precursor B acute lymphoblastic leukaemia. Other studies have reported marrow fibrosis 4 or increased vascularity 5 in some acute lymphoblastic leukaemia (ALL) patients, but have not found a prognostic significance associated with higher levels.…”

Small bone marrow adipocytes predict poor prognosis in acute myeloid leukemia

“…However, a multivariate Cox regression showed that only the volume and number of small adipocytes were associated with a high risk of relapse and death in the AML patients (Online Supplementary Table S3). The cut-off values for KaplanMeier survival analysis were decided to be the quartiles of the small adipocyte volume and number in Cox analyses, 9 and the values that had the highest hazard ratio were used as the optimal cut-off values (Online Supplementary Table S4). Patients with more small adipocytes (small adipocyte volume ≥2.3% or small adipocyte number ≥17.0/mm 2 ) had a shorter overall survival compared with the others (average overall survival 11.5 months versus 44.1 months, or 5.9 months versus 33.0 months, respectively, P<0.001) (Figure 2A,B).…”