The bone marrow fibrosis observed in primary myelofibrosis is due to:
a. Malignant proliferation of fibroblasts
b. Increased erythropoietin, which stimulates fibroblast proliferation
c. Increased release of fibroblastic growth factors such as platelet-derived growth factor
d. Decreased apoptosis of normal fibroblasts
ANS: C
An increased release of fibroblastic growth factors occurs, including platelet-derived growth factor, in primary myelofibrosis; this results in fibrosis. The fibroblasts in primary myelofibrosis are normal, not malignant.
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