Marrow fibrosis and multiple myeloma

A retrospective review of pretreatment bone marrow material from 297 patients diagnosed and treated for multiple myeloma (MM) at a single institution during a 22-year period (1961-1982) was performed in order to assess the frequency and significance of associated simple marrow fibrosis (SMF). The presence of SMF was suspected in the hematoxylin and eosin-stained sections in 48 of the 297 cases and was confirmed by reticulin stains in 26 (8.8%) cases, with seven of these also showing collagen on trichrome stain. However, the literature on MM documents little recognition of this association. SMF is often responsible for inadequate marrow aspirates yielding spurious or inconclusive results. Thus, bone marrow trephine biopsies may be required to histologically confirm the diagnosis of MM when there is concurrent SMF.