{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:10:54Z","timestamp":1772118654271,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n This study, including 412 patients newly diagnosed with myelodysplastic neoplasm (MDS), investigated the clinical, molecular, and prognostic features of MDS with moderate\u2010to\u2010severe bone marrow fibrosis (MF). Among the patients with MDS, 347 (84%) had MF grade 0\u20131 (MF0\u20131), and 65 (16%) had MF grade 2\u20133 (MF2\u20133). Patients with MDS with MF2\u20133 showed similar overall survival (OS) (16.6 vs. 21.3\u00a0months;\n p<\/jats:italic>\n \u00a0=\u00a00.34) but demonstrated inferior progression\u2010free survival (PFS) (6.6 vs. 15.2\u00a0months;\n p<\/jats:italic>\n \u00a0=\u00a00.02) and a higher risk of leukemia transformation (35.4 vs. 16.4%;\n p<\/jats:italic>\n \u00a0<\u00a00.001) compared to those with MF0\u20131. In the MDS with excess blast (MDS\u2010EB) subtypes, individuals with MF2\u20103 exhibited shorter OS (4.8 vs. 11.7\u00a0months;\n p<\/jats:italic>\n \u00a0=\u00a00.01) and PFS (3.1 vs. 7.9\u00a0months;\n p<\/jats:italic>\n \u00a0=\u00a00.006) than those in patients with MF0\u20101. However, individuals with MF0\u20101 and MF2\u20103 showed similar OS and PFS rates among the patients with the MDS non\u2010excess blast (MDS\u2010nonEB) subtypes. Additionally, we reclassified the patients with MDS according to the 2022 World Health Organization (WHO) classification. Patients with MDS with fibrosis (MDS\u2010f) had a shorter OS (5.6 vs. 13.8\u00a0months;\n p<\/jats:italic>\n \u00a0=\u00a00.01) and PFS (3.1 vs. 7.9\u00a0months;\n p<\/jats:italic>\n \u00a0=\u00a00.006) than MDS with increased blasts (MDS\u2010IB) subtypes. Our study reveals the unique features of patients with MDS\u2010MF2\u20103 and validates the refinements made in the 5th edition of the WHO proposal.\n <\/jats:p>","DOI":"10.1002\/hon.70043","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T07:50:51Z","timestamp":1738569051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Moderate\u2010To\u2010Severe Bone Marrow Fibrosis Is an Independent Risk Factor For Myelodysplastic Neoplasms Patients With Increased Blasts"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4932-5813","authenticated-orcid":false,"given":"Gaixiang","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China"},{"name":"Zhejiang Provincial Key Laboratory of Hematopoietic Malignancy Zhejiang University Hangzhou 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