Myelodysplastic syndromes with bone marrow fibrosis.

The pathophysiology of bone marrow fibrosis inmyelodysplastic syndromes is just beginning to be elucidated. Most diseases with increased bone marrow fibrosis are associated with abnormalities of the number and/or function of megakaryocytes and platelets. Cytokines from megakaryocytes and platelets appear to be necessary, but perhaps not sufficient, for fibrosis to occur. The clinical significance of bone marrow fibrosis in MDS patients remains to be clarified. The current classification of MDS is based on morphological evaluation of bone marrow dysplasia and does not take into account histological features. However, histological information complements the morphological information obtained from a marrow aspirate and diagnostic guidelines recommend that a biopsy should be performed in all cases of suspected MDS in which bone marrow examination is indicated.