Table 8

Grading of myelofibrosis

Myelofibrosis grading
MF-0 Scattered linear reticulin with no intersections (crossovers) corresponding to normal BM 
MF-1 Loose network of reticulin with many intersections, especially in perivascular areas 
MF-2 Diffuse and dense increase in reticulin with extensive intersections, occasionally with focal bundles of thick fibers mostly consistent with collagen, and/or focal osteosclerosis* 
MF-3 Diffuse and dense increase in reticulin with extensive intersections and coarse bundles of thick fibers consistent with collagen, usually associated with osteosclerosis* 
Myelofibrosis grading
MF-0 Scattered linear reticulin with no intersections (crossovers) corresponding to normal BM 
MF-1 Loose network of reticulin with many intersections, especially in perivascular areas 
MF-2 Diffuse and dense increase in reticulin with extensive intersections, occasionally with focal bundles of thick fibers mostly consistent with collagen, and/or focal osteosclerosis* 
MF-3 Diffuse and dense increase in reticulin with extensive intersections and coarse bundles of thick fibers consistent with collagen, usually associated with osteosclerosis* 

Semiquantitative grading of BM fibrosis (MF) with minor modifications concerning collagen and osteosclerosis. Fiber density should be assessed only in hematopoietic areas.

*

In grades MF-2 or MF-3 an additional trichrome stain is recommended.

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