Abstract
Idiopathic myelofibrosis (IMF) is a hematopoietic stem cell disorder with hypercellular bone marrow and an increase in abnormal megakaryocytes, varying degrees of marrow fibrosis, and extramedullary hematopoiesis. Increased production platelet derived grows factor by megakaryocytes couses increased activity of fibroblasts and development of bone marrow fibrosis in idiopathic myelofibrosis. Numarical and morphological alteration and defective megakaryocytic development in idiopathic myelofibrosis was shown in the previous study. However, the degree of differentiation and functional activities of megakaryocytes still unknown. The morphology of megakaryocytes was evaluated in smears of bone marrow from 12 patients with idiopathic myelofibrosis in chronic stage and 12 patients without hematology disorders (control group). Megakaryocytes was separated on megakaryoblasts, promegakaryocytes, basophilic, polychromatophilic, oxyphilic megakaryocytes and naked (bare) nuclei of megakaryocytes. Functional activity of megakaryocytes (megakaryocytes with platelet formation) connect with degree of differentiation were evaluated. Number of lobule of megakaryocytes was accounted. The analysis of megakaryocytogram revealed the presence of atypical megakaryocytes (cell with abnormal immature cytoplasm and pyknotic nuclei, cell with separated one or all lobules of nuclei, vacuolated megakaryocytes). In group with idiopathic myelofibrosis the number of naked nuclear was prominently increased (p<0,01) compare with control group. These cell accounted up to 36% in average of all megakaryopoietic elements. The number of functional activity megakaryocytes in group with idiopathic myelofibrosis was increased on 30%. But, in this group appear active platelet formation accompanied with pycnotic nuclei (platelets had prominent basophilic cytoplasm). Content of basophilic, polychromatophilic and oxyphilic megakaryocytes did not differ statistically group of study and control group. In group with idiopathic myelofibrosis the number of promegakaryocytes and hyperlobulated megakaryocytes was increased in comparison with control group. These data show the up-regulation of megakaryocytic cells in bone marrow in idiopathic myelofibrosis. An increase in number of promegakaryocytes, naked nuclei, active platelet formation accompanied with pyknotic nuclei, hyperlobulated megakaryocytes is characteristic for idiopathic myelofibrosis
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