{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:44:05Z","timestamp":1790721845867,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,11,20]],"date-time":"2015-11-20T00:00:00Z","timestamp":1447977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>In the era of potentially disease\u2010modifying agents such as Janus kinase inhibitors, accurate grading and differentiation of bone marrow (<jats:styled-content style=\"fixed-case\">BM<\/jats:styled-content>) fibrosis has become more relevant to assess staging of disease and therapeutic effects. However, different fibrosis grading models have been used in the past without uniformity, including the proposal by the World Health Organization. Current scoring systems are based only on reticulin fibrosis. Therefore, additional assessment of collagen and the grade of osteosclerosis appear to be essential to discriminate all components of the complex <jats:styled-content style=\"fixed-case\">BM<\/jats:styled-content> fibrous matrix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We evaluated problems and pitfalls regarding staining techniques and the interpretation of reticulin fibrosis on a total of 352 samples. Furthermore, we propose a minor modification of the current grading and separate scoring for collagen deposition and osteosclerosis. Reproducibility of gradings was tested among 11 haematopathologists in a blinded assessment. Overall, the inter\u2010rater reliability of all three grading systems ranged between 0.898 and 0.926.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A standardized assessment of <jats:styled-content style=\"fixed-case\">BM<\/jats:styled-content> fibrosis with differentiation between reticulin, collagen and osteosclerosis is recommended to evaluate the various components of the fibrous matrix which may be delinked after therapy. In this regard, quality of staining and application of laboratory standards enable a highly reproducible scoring.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.12871","type":"journal-article","created":{"date-parts":[[2015,9,24]],"date-time":"2015-09-24T13:34:45Z","timestamp":1443101685000},"page":"905-915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Problems and pitfalls in grading of bone marrow fibrosis, collagen deposition and osteosclerosis \u2013 a consensus\u2010based study"],"prefix":"10.1111","volume":"68","author":[{"given":"Hans Michael","family":"Kvasnicka","sequence":"first","affiliation":[{"name":"Senckenberg Institute of Pathology University of Frankfurt Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Beham\u2010Schmid","sequence":"additional","affiliation":[{"name":"Institute of Pathology Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshanak","family":"Bob","sequence":"additional","affiliation":[{"name":"Berlin Reference and Consultation Centre for Lymphoma and Hematopathology Pathodiagnostik Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Dirnhofer","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kais","family":"Hussein","sequence":"additional","affiliation":[{"name":"Institute of Pathology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Kreipe","sequence":"additional","affiliation":[{"name":"Institute of Pathology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Kremer","sequence":"additional","affiliation":[{"name":"Institute of Pathology Staedtisches Klinikum Muenchen Muenchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Schmitt\u2010Graeff","sequence":"additional","affiliation":[{"name":"Institute of Surgical Pathology University Hospital Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Pathology University Medical Centre Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Thiele","sequence":"additional","affiliation":[{"name":"Institute of Pathology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Werner","sequence":"additional","affiliation":[{"name":"Institute of Surgical Pathology University Hospital Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Stein","sequence":"additional","affiliation":[{"name":"Berlin Reference and Consultation Centre for Lymphoma and Hematopathology Pathodiagnostik Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-005-0042-8"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-393819"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2013.109"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2405030"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2013.187"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-013-1776-3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.18.2246"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.31.4.313"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2011.128"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08845.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2005.04.010"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exphem.2007.08.022"},{"key":"e_1_2_8_14_1","first-page":"879","article-title":"Dynamics of bone marrow changes in patients with chronic idiopathic myelofibrosis following allogeneic stem cell transplantation","volume":"20","author":"Thiele J","year":"2005","journal-title":"Histol. Histopathol."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-03-009746"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.9.2954"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000101708"},{"key":"e_1_2_8_18_1","first-page":"993","article-title":"Silver impregnation of reticulum in paraffin sections","volume":"13","author":"Gomori G","year":"1937","journal-title":"Am. J. Pathol."},{"key":"e_1_2_8_19_1","first-page":"493","article-title":"The effect of certain factors on the results of silver impregnation for reticulum fibers","volume":"15","author":"Gomori G","year":"1939","journal-title":"Am. J. Pathol."},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2005.02302.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06807.x"},{"key":"e_1_2_8_22_1","first-page":"1128","article-title":"European consensus on grading bone marrow fibrosis and assessment of cellularity","volume":"90","author":"Thiele J","year":"2005","journal-title":"Haematologica"},{"key":"e_1_2_8_23_1","volume-title":"WHO classification of tumours of haematopoietic and lympoid tissues","author":"Swerdlow S","year":"2008"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/0471445428"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0031619"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.86.2.420"},{"key":"e_1_2_8_27_1","unstructured":"GamerM LemonJ FellowsI SingP.Various coefficients of interrater reliability and agreement (version 0.84). Available at:http:\/\/CRAN.R-project.org\/package=irr. Accessed 1 August 2014."},{"key":"e_1_2_8_28_1","first-page":"239","article-title":"Therapy\u2010related changes of the bone marrow in chronic idiopathic myelofibrosis","volume":"19","author":"Thiele J","year":"2004","journal-title":"Histol. Histopathol."},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/1042819031000077070"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1309\/PTVGB3DXB8A8M7KD"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000101706"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2005.05.020"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2005.07.015"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27930"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-09-112953"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2012.87"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-003-0719-9"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-942757"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970815)80:4<708::AID-CNCR9>3.0.CO;2-I"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23384"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2006.07.008"},{"key":"e_1_2_8_42_1","first-page":"1","article-title":"Clinical and laboratory features of myelofibrosis and limitations of current therapies","volume":"9","author":"Gregory SA","year":"2011","journal-title":"Clin. Adv. Hematol. Oncol."},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110556"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1002028"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-02-414631"},{"issue":"1","key":"e_1_2_8_46_1","first-page":"S591","article-title":"Long term effects of ruxolitinib therapy on bone marrow morphology in patients with myelofibrosis in comparison with best available therapy","volume":"98","author":"Kvasnicka HM","year":"2013","journal-title":"Haematologica"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V122.21.4055.4055"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/56.1.24"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1979.tb03740.x"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-05-091850"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2014.69"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2013.196"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23554"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00492078"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.1700430311"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhis.12871","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.12871","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/his.12871","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.12871","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T15:26:48Z","timestamp":1696346808000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.12871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,20]]},"references-count":54,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1111\/his.12871"],"URL":"https:\/\/doi.org\/10.1111\/his.12871","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11,20]]},"assertion":[{"value":"2015-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-11-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}