{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:56:29Z","timestamp":1792443389012,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T00:00:00Z","timestamp":1506556800000},"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":["Histopathology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate whether a comprehensive histological evaluation of reticulin fibrosis, collagen deposition and osteosclerosis in bone marrow trephine biopsies (<jats:styled-content style=\"fixed-case\">BMB<\/jats:styled-content>s) of primary myelofibrosis (<jats:styled-content style=\"fixed-case\">PMF<\/jats:styled-content>) patients may have prognostic implications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Reticulin fibrosis, collagen deposition and osteosclerosis were graded from 0 to 3 in a series of 122 baseline <jats:styled-content style=\"fixed-case\">BMB<\/jats:styled-content>s. Then, we assigned to each case a comprehensive score [reticulin, collagen, osteosclerosis (<jats:styled-content style=\"fixed-case\">RCO<\/jats:styled-content>) score, ranging from 0 to 9] that allowed us to distinguish two groups of patients, with low\u2010grade (<jats:styled-content style=\"fixed-case\">RCO<\/jats:styled-content> score 0\u20134) and high\u2010grade (<jats:styled-content style=\"fixed-case\">RCO<\/jats:styled-content> score 5\u20139) stromal changes. Of 122 patients, 88 displayed a low\u2010grade and 34 a high\u2010grade <jats:styled-content style=\"fixed-case\">RCO<\/jats:styled-content> score. The latter was associated more frequently with anaemia, thrombocytopenia, peripheral blood blasts and increased lactate dehydrogenase levels. The <jats:styled-content style=\"fixed-case\">RCO<\/jats:styled-content> score was correlated strictly with overall mortality (<jats:italic>P<\/jats:italic> = 0.013) and International Prognostic Scoring System (<jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content>) risk categories, and was able to discriminate the overall survival of both low\u2010 and high\u2010grade patients (log\u2010rank test: <jats:italic>P<\/jats:italic> &lt; 0.001). Moreover, it proved to be more accurate than the European Consensus on Grading of Bone Marrow Fibrosis (<jats:styled-content style=\"fixed-case\">ECGMF<\/jats:styled-content> grade) in identifying high\u2010risk patients with poor prognosis. Finally, a combined analysis of <jats:styled-content style=\"fixed-case\">RCO<\/jats:styled-content> scores and <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content> risk categories in an integrated clinical\u2013pathological evaluation was able to increase the positive predictive value (<jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>) for mortality in high\u2010risk patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The comprehensive <jats:styled-content style=\"fixed-case\">RCO<\/jats:styled-content> score, obtained by histological evaluation of reticulin fibrosis, collagen deposition and osteosclerosis was prognostically significant and more accurate than <jats:styled-content style=\"fixed-case\">ECGMF<\/jats:styled-content> grade in identifying high\u2010risk patients and improved <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content> when applied in addition to <jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13309","type":"journal-article","created":{"date-parts":[[2017,7,15]],"date-time":"2017-07-15T06:36:40Z","timestamp":1500100600000},"page":"897-908","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Prognostic significance of a comprehensive histological evaluation of reticulin fibrosis, collagen deposition and osteosclerosis in primary myelofibrosis patients"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3304-8417","authenticated-orcid":false,"given":"Umberto","family":"Gianelli","sequence":"first","affiliation":[{"name":"Division of Pathology Department of Pathophysiology and Transplantation University of Milan and IRCCS Ca\u2019 Granda Maggiore Policlinico Hospital Foundation Milan 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Cortinovis","sequence":"additional","affiliation":[{"name":"Laboratory GA Maccacaro Department of Clinical Sciences and Community Health University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Bonometti","sequence":"additional","affiliation":[{"name":"Division of Pathology Department of Pathophysiology and Transplantation University of Milan and IRCCS Ca\u2019 Granda Maggiore Policlinico Hospital Foundation Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Ercoli","sequence":"additional","affiliation":[{"name":"Division of Pathology Department of Pathophysiology and Transplantation University of Milan and IRCCS Ca\u2019 Granda Maggiore Policlinico Hospital Foundation Milan 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