• The classic myeloproliferative neoplasms, including chronic myelogenous leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are a phenotypically diverse category of malignancies that are derived from stem cells in the myeloid lineage. (mhmedical.com)
  • the former constitutes the topic of this chapter and includes chronic myelogenous leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). (mhmedical.com)
  • Chronic myelogenous leukemia (CML). (booksca.ca)
  • Bone marrow fibrosis is also detected in the spent phase of chronic myelogenous leukemia and polycythemia vera. (medscape.com)
  • Hematopoietic stem cell transplantation can be considered in young patients with chronic myelogenous leukemia in chronic phase if a human leukocyte antigen (HLA)-matched donor is available. (medscape.com)
  • in particular, patients with rare diseases like spinal muscular atrophy and certain cancers such as chronic myelogenous leukemia may now be prescribed personalized medicine treatments that simply didn't exist a couple of decades ago. (cdc.gov)
  • It can also be used in cases of chronic myeloid leukemia (CML, also called chronic myelogenous leukemia) that have entered the aggressive blast phase - although kinase inhibitors have replaced chemotherapy in most of these cases. (mympnteam.com)
  • Chronic myelogenous leukemia is a disease in which too many white blood cells are made in the bone marrow . (cancerhealth.com)
  • See the PDQ summary on Chronic Myelogenous Leukemia Treatment for information on diagnosis , staging , and treatment. (cancerhealth.com)
  • As of 2016, the World Health Organization lists the following subcategories of MPNs: Chronic myeloid leukemia (CML) Chronic neutrophilic leukemia (CNL) Polycythemia vera (PV) Primary myelofibrosis (PMF) PMF, Prefibrotic Stage PMF, Overt Fibrotic Stage Essential thrombocythemia (ET) Chronic eosinophilic leukemia (not otherwise specified) MPN, unclassifiable (MPN-U) MPNs arise when precursor cells (blast cells) of the myeloid lineages in the bone marrow develop somatic mutations which cause them to grow abnormally. (wikipedia.org)
  • Depending on the nature of the myeloproliferative neoplasm, diagnostic tests may include red cell mass determination (for polycythemia), bone marrow aspirate and trephine biopsy, arterial oxygen saturation and carboxyhaemoglobin level, neutrophil alkaline phosphatase level, vitamin B12 (or B12 binding capacity), serum urate or direct sequencing of the patient's DNA. (wikipedia.org)
  • 1,2 The 4 primary disorders of MPNs are chronic myeloid leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). (oncomine.com)
  • The overproduction of red blood cells characterizes polycythemia vera (PV), 1 of the 3 commonly classical Philadelphia chromosome-negative, or BCR-ABL, myeloproliferative neoplasms. (oncomine.com)
  • See also " Polycythemia vera " and " Chronic myeloid leukemia " for further detail on these conditions. (amboss.com)
  • INTRODUCTION - An overview of the four classic myeloproliferative neoplasms (MPN): polycythemia vera, essential thrombocythemia, primary myelofibrosis, and chronic myeloid leukemia will be presented here. (medilib.ir)
  • MPNs include polycythemia vera, essential thrombocythemia, chronic myeloid leukemia (CML), primary myelofibrosis, chronic neutrophilic leukemia, and other less well defined entities such as chronic eosinophilic leukemia, not otherwise categorized. (medilib.ir)
  • RUNX1 mutations have been reported in approximately 10% of myelodysplastic cases, 5-15% of acute myeloid leukemia, 8-37% of chronic myelomonocytic leukemia, 10% of T cell acute lymphoblastic leukemia, 3% of systemic mastocytosis, 2% of essential thrombocythemia and 2% of polycythemia vera. (cornell.edu)
  • Primary myelofibrosis, also known as idiopathic myelofibrosis and agnogenic myeloid metaplasia, is a malignant disease, one of the chronic myeloproliferative neoplasms, along with polycythemia vera and essential thrombocythemia, amongst others (see table 1). (fcarreras.org)
  • Polycythemia vera (PV) is a chronic myeloproliferative neoplasm characterized by the overproduction of RBCs. (lecturio.com)
  • Myeloproliferative neoplasms (MPN), rare types (Chronic eosinophilic leukemia, Chronic neutrophilic leukemia). (booksca.ca)
  • Less common MPNs, which are not associated with the driver mutations, include chronic eosinophilic leukemia (CEL), chronic neutrophilic leukemia , and myeloproliferative neoplasm , unclassifiable. (amboss.com)
  • Acute eosinophilic leukemia. (oncohemakey.com)
  • The blast percentage, marked dysmorphia of eosinophils, and the patient's course was consistent with acute eosinophilic leukemia. (oncohemakey.com)
  • What were the results of the MPN ( myeloproliferative neoplasm) Study of the add-on of Parsaclisib to Ruxolitinib therapy? (oncologytube.com)
  • Novel BCR-ABL1 fusion identified by targeted next-generation sequencing in a patient with an atypical myeloproliferative neoplasm. (jefferson.edu)
  • The type of myeloproliferative neoplasm is based on whether too many red blood cells, white blood cells, or platelets are being made. (cancerhealth.com)
  • BACKGROUND Essential thrombocytosis (ET) is a myeloproliferative neoplasm variant that leads to excessive platelet production in the bone marrow. (bvsalud.org)
  • AML is defined by the presence of either 20 percent or more bone marrow/peripheral blood myeloblasts (or promyelocytes in case of acute promyelocytic leukemia) or AML-specific cytogenetic abnormalities such as t(8;21)(q22;q22), t(15;17)(q22;q12) and inv(16)(p13q22). (mhmedical.com)
  • In addition to G-CSF, the use of ATRA in the context of acute promyelocytic leukemia has shown the propagation of aberrant neutrophils as seen in drug-induced Sweet syndrome. (medscape.com)
  • ALL - Acute lymphoblastic leukemia, AML - Acute myeloid leukemia, APL - Acute promyelocytic leukemia, CLL - Chronic lymphocytic leukemia, CML - Chronic myeloid leukemia, and childhood leukemia are all types of Leukemia. (mediflam.com)
  • There is a similar category of disease for the lymphoid lineage, the lymphoproliferative disorders acute lymphoblastic leukemia, lymphomas, chronic lymphocytic leukemia and multiple myeloma. (wikipedia.org)
  • U2AF1 expression is a novel and independent prognostic indicator of childhood T-lineage acute lymphoblastic leukemia. (cdc.gov)
  • These malignancies are further characterized by the maturity and differentiation of the individual cell types and are divided into acute leukemias such as acute myeloid leukemia and acute lymphoblastic leukemia and chronic leukemias such as chronic myeloid leukemia and chronic lymphocytic leukemia. (medscape.com)
  • Pharmacotypes across the genomic landscape of pediatric acute lymphoblastic leukemia and impact on treatment response. (cdc.gov)
  • Association of Inherited Genetic Factors With Drug-Induced Hepatic Damage Among Children With Acute Lymphoblastic Leukemia. (cdc.gov)
  • The 2008 World Health Organization (WHO) classification system considers five broad categories of myeloid malignancies: acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), myeloproliferative neoplasms (MPNs), MDS/MPN overlap, and molecularly characterized MPN with eosinophilia 1 ( Table 78-1 ). (mhmedical.com)
  • With an ever-growing list of biomarkers, inherent genetic complexity, and the risk of rapid progression, myeloid malignancies challenge the current iterative testing paradigm and call for a streamlined testing approach that yields rapid results. (oncomine.com)
  • 3 Results can be available within hours or days, depending on the platform.3 With its demonstrated clinical utility in myeloid malignancies, NGS is transforming the testing paradigm and enabling better outcomes for patients. (oncomine.com)
  • Myeloid malignancies arise from mutations in hematopoietic stem or progenitor cells. (oncomine.com)
  • 6] Case reports have described AN associated with hematologic malignancies, including acute myeloid leukemia, and even benign gastrointestinal neoplasms. (medscape.com)
  • CLASSIFICATION OF HEMATOLOGIC MALIGNANCIES - The hematopoietic pluripotent stem cell is capable of both self-renewal and stepwise differentiation into either the lymphoid or myeloid lineage (which appears to be determined stochastically) [ 1 ]. (medilib.ir)
  • Imago is a clinical stage biopharmaceutical company developing new medicines for the treatment of myeloproliferative neoplasms (MPNs) and other bone marrow diseases. (merck.com)
  • Myeloproliferative neoplasms (MPNs) are a group of rare blood cancers in which excess red blood cells, white blood cells or platelets are produced in the bone marrow. (wikipedia.org)
  • In rare cases, some MPNs such as primary myelofibrosis may accelerate and turn into acute myeloid leukemia. (wikipedia.org)
  • In MPNs, the neoplasm (abnormal growth) starts out as benign and can later become malignant. (wikipedia.org)
  • Myeloproliferative neoplasms (MPNs) are a group of disorders characterized by a proliferation of normally developed (nondysplastic) multipotent hematopoietic stem cells from the myeloid cell line . (amboss.com)
  • Purpose: The objectives of this study were 1) to assess PV reporting to the PCR in 2006-2009, 2) to determine whether a cancer cluster persisted, and 3) to determine whether other myeloproliferative neoplasms (MPNs), including essential thrombocytopenia (ET), were subject to similar reporting problems. (cdc.gov)
  • ATSDR used findings to estimate PV incidence neoplasms (MPNs). (cdc.gov)
  • The results of this evalu- ized by bone marrow proliferation and peripheral blood ation indicated that inaccurate reporting of PV to the PCR erythrocytosis, thrombocytosis, or granulocytoses.1 In addi- led to PV risk estimates that were inflated over true values tion to PV, the MPNs include chronic myeloid leukemia by 13% to 62%2. (cdc.gov)
  • CML), essential thrombocytopenia (ET), primary myeloid significant cluster of PV cases near the intersection of the 3 fibrosis (PMF), and other related and unclassifiable MPNs, counties. (cdc.gov)
  • There was also a decrease in the absolute median change, and the median change of symptoms related to myeloproliferative neoplasms (MPNS), according to the MPN Symptom Assessment Form Total Symptom Score (MPN-SAF TSS). (targetedonc.com)
  • Myeloproliferative neoplasms (MPNs) are blood conditions caused by genetic mutations in blood stem cells in the bone marrow. (mympnteam.com)
  • Acute febrile neutrophilic dermatosis, also termed Sweet syndrome, is a reactive process characterized by the abrupt onset of tender, red-to-purple papules, and nodules that coalesce to form plaques. (medscape.com)
  • Acute febrile neutrophilic dermatosis (Sweet syndrome) is a reactive process (a hypersensitivity reaction) that occurs in response to systemic factors, such as hematologic disease, infection, inflammation, vaccination, or drug exposure. (medscape.com)
  • Acute febrile neutrophilic dermatosis (Sweet syndrome) is uncommon but not rare. (medscape.com)
  • Acute febrile neutrophilic dermatosis (Sweet syndrome) has no known racial predilection. (medscape.com)
  • The common reactive variant of acute febrile neutrophilic dermatosis (Sweet syndrome) does have a female predominance, with a female-to-male ratio of 15:1. (medscape.com)
  • Typically, women with acute febrile neutrophilic dermatosis (Sweet syndrome) are aged 30-50 years. (medscape.com)
  • Robert Douglas Sweet first described acute febrile neutrophilic dermatosis in 1964, leading to the eponym Sweet syndrome (SS). (medscape.com)
  • 5 Hematopoietic disruptions in the myeloid lineage can lead to 3 major disease categories: acute myeloid leukemia (AML), myeloproliferative neoplasms (MPN), and myelodysplastic syndrome (MDS). (oncomine.com)
  • Decreased WBC count, leukopenia, is seen when supply is depleted by infection or treatment such as chemotherapy or radiation therapy, or when a hematopoietic stem cell abnormality does not allow normal growth/maturation within the bone marrow, such as myelodysplastic syndrome or leukemia. (medscape.com)
  • RUNX1 mutations are independently associated with unfavorable outcomes and shorter survival after hematopoietic stem cell transplantation in patients with myelodysplastic syndrome and myelodysplastic syndrome/acute myeloid leukemia. (cornell.edu)
  • Whole-genome sequencing of chronic lymphocytic leukemia identifies subgroups with distinct biological and clinical features. (cdc.gov)
  • Chronic myelomonocytic leukemia (CMML). (booksca.ca)
  • Juvenile myelomonocytic leukemia (JMML). (booksca.ca)
  • Are next-generation sequencing results knocking on Heaven's door for transplantation planning in chronic myelomonocytic leukemia? (haematologica.org)
  • ASXL1 mutations have been reported in 40-50% of chronic myelomonocytic leukemia(CMML), 20% of myelodsyplastic syndromes, 20-35% of primary myelofibrosis, 15% of systemic mastocytosis, 30% of patients with secondary acute myeloid leukemia and 5-10% of primary acute myeloid leukemia. (cornell.edu)
  • Nonsense and frameshift mutations (but apparently not missense mutations) of ASXL1 have been reported to carry an adverse prognostic impact in cases of chronic myelomonocytic leukemia. (cornell.edu)
  • RUNX1 mutations are also associated with an unfavorable prognosis chronic myelomonocytic leukemia and systemic mastocytosis. (cornell.edu)
  • AML, NOS/AML with dysplasia-related changes/therapy-related myeloid neoplasm. (booksca.ca)
  • AML with RUNX1 mutation which does not fulfill the diagnostic criteria for other specific AML subtypes in the categories of AML with recurrent genetic abnormalities, therapy-related myeloid neoplasms, or AML with myelodysplasia-related changes is now classified the provisional entity of AML with mutated RUNX1. (cornell.edu)
  • We look forward to working with the Imago team to further investigate the potential of bomedemstat for patients with myeloproliferative neoplasms. (merck.com)
  • Patients with otherwise unexplained thrombosis and with neoplasms that cannot be classified in one of the other categories. (wikipedia.org)
  • Patients with acute myocardial infarction experience a transient but significant rise in serum IL-8 concentration within 24 hours after the onset of symptoms. (medscape.com)
  • Dasatinib (Sprycel): Indicated for the treatment of adult patients with chronic myeloid leukemia in chronic, accelerated, or myeloid or lymphoid blast phase who are resistant or intolerant to prior therapy including imatinib. (medscape.com)
  • Mutational landscape of patients with acute myeloid leukemia or myelodysplastic syndromes in the context of RUNX1 mutation. (cdc.gov)
  • Defining Acute Myeloid Leukemia Ontogeny in Older Patients. (cdc.gov)
  • Patients are kept under close observation because of the risk of developing acute myeloid leukemia ( AML ). (amboss.com)
  • Although the incidence of acute nonlymphocytic leukemia is increased in PV, the incidence of acute leukemia in patients not exposed to chemotherapy or radiation therapy is low. (basicmedicalkey.com)
  • Interestingly, chemotherapy, including hydroxyurea, has been associated with acute leukemia in JAK2 V617F-negative stem cells in some PV patients. (basicmedicalkey.com)
  • In the efficacy analysis of patients with CSF3R wild type and CSF3R- mutant myeloid neoplasms, all changes in disease characteristics decreased after 6 cycles of ruxolitinib treatment except platelet counts and spleen reduction. (targetedonc.com)
  • ONUREG is a nucleoside metabolic inhibitor indicated for continued treatment of adult patients with acute myeloid leukemia who achieved first complete remission (CR) or complete remission with incomplete blood count recovery (CRi) following intensive induction chemotherapy and are not able to complete intensive curative therapy ( 1 ). (nih.gov)
  • Myeloid neoplasms, predominantly MDS/AML, developing in patients, usually at a young age, with a familial platelet disorder and germline monoallelic RUNX1 mutations are categorized as myeloid neoplasms with germline RUNX1 mutation. (cornell.edu)
  • From the article: 'In a real-world setting of new and emerging targeted therapies, a study found that patients with acute myeloid leukemia (AML) had unmet needs that hindered their ability to receive genomic testing and treatment options, especially for older patients with AML. (cdc.gov)
  • Myeloproliferative diseases are a heterogeneous group of disorders characterized by cellular proliferation of one or more hematologic cell lines in the peripheral blood, distinct from acute leukemia. (medscape.com)
  • With the absence of a standard of care for chronic neutrophilic leukemia and atypical chronic myeloid leukemia, 2 rare BCR-ABL1-negative myeloid neoplasms, ruxolitinib may be a viable treatment option after a phase II study showed potential for response in this patient population. (targetedonc.com)
  • Clinical analysis of 12 cases of acute myeloid leukemia complicated with synchronous primary solid tumor]. (cdc.gov)
  • Renal cell carcinoma is responsible for 80%-85% of all primary renal neoplasms. (lecturio.com)
  • Analyzing samples from 805 children with newly diagnosed ALL from three consecutive clinical trials, we determined the ex vivo sensitivity of primary leukemia cells to 18 therapeutic agents across 23 molecular subtypes defined by leukemia genomics. (cdc.gov)
  • According to WHO diagnostic criteria published in 2016, myeloproliferative neoplasms are diagnosed as follows: Chronic myeloid leukemia (CML) has a presence of the hallmark Philadelphia Chromosome (BCR-ABL1) mutation. (wikipedia.org)
  • Chronic neutrophilic leukemia (CNL) is characterized by a mutation in the CSF3R gene and an exclusion of other causes of neutrophilia. (wikipedia.org)
  • Characterized by excessive, abnormal white blood cell (granulocyte) production and the presence of the Philadelphia chromosome/BCR-ABL mutation, chronic myeloid leukemia (CML) is a slow-growing cancer of the blood-forming tissue (bone marrow). (oncomine.com)
  • JAK2 mutation was positive, which led to myeloproliferative neoplasms being considered as the differential diagnosis. (bvsalud.org)
  • Recently, activating mutations in JAK2 and MPL have been found in the majority of BCR-ABL -negative myeloproliferative neoplasms. (mhmedical.com)
  • The natural process of blood cell formation, hematopoietic stem cell differentiation, and generation of myeloid and lymphoid cell lineages. (oncomine.com)
  • Some persons with clonal hematopoiesis are at increased risk for the development of myeloid cancers such as acute myeloid leukemia or myelodysplastic syndromes, a risk that increases as the hematopoietic clone expands in size.16 Stopping this expansion may delay or avert leukemic progression, and therapeutic approaches to this end are being developed and tested. (cdc.gov)
  • Peripheral smear of a patient with agnogenic myeloid metaplasia (myelofibrosis) shows leukoerythroblastosis. (medscape.com)
  • For instance, the anterior mediastinum is the site of the thymus with its varied associated pathology from Hodgkin and non-Hodgkin lymphoma (NHL), to thymoma, to germ cell neoplasms. (basicmedicalkey.com)
  • Leukemia and Lymphoma. (elsevierpure.com)
  • In large cell lymphoma and leukemia cells involvement of body fluid this concept becomes less challenging. (cytojournal.com)
  • Large cell lymphoma and leukemia cells tend to have large size nuclei, less mature chromatin, and visible nucleoli with and without cytoplasmic vacuoles. (cytojournal.com)
  • These are the malignant proliferations of abnormal clones of white blood cells within the bone marrow that are broadly categorized into lymphoid and myeloid neoplasms depending on the type of white cell proliferation. (medscape.com)
  • In these diseases the stem cells in the bone marrow, responsible for producing all the blood cells, have acquired a genetic defect which makes them produce one of the myeloid lineage blood cells in an uncontrolled manner. (fcarreras.org)
  • All the cancers that arise in the bone marrow are known as Leukemia. (mediflam.com)
  • CSF3R T618I, SETBP1 G870S, SRSF2 P95H, and ASXL1 Q780* tetramutation co-contribute to myeloblast transformation in a chronic neutrophilic leukemia. (cdc.gov)
  • Myeloproliferative neoplasms present with the clonal proliferation of 1 or more myeloid cell lineages.10 The role of genetic and genomic aberrations in pathogenesis has been well documented for these disorders. (oncomine.com)
  • Clonal studies in the chronic myeloid disorders - Genetic and enzyme studies based upon X-chromosome inactivation patterns have revealed a multipotent progenitor cell origin for the neoplastic clone in both MDS [ 8 ] and MPN [ 9 ]. (medilib.ir)
  • This genetic alteration is not hereditary (it is not transmitted from parents to their offspring), although some families have a predisposition to develop myeloproliferative neoplasms. (fcarreras.org)
  • Myeloid and lymphoid neoplasm with eosinophilia and abnormalities of PDGFRA, PDGFRB, or FGFR1. (booksca.ca)
  • BCR-ABL1 mediated miR-150 downregulation through MYC contributed to myeloid differentiation block and drug resistance in chronic myeloid leukemia. (jefferson.edu)
  • Myeloproliferative neoplasms are a group of diseases of the bone marrow characterized by excessive production of red blood cells, platelets, or certain white blood cells. (merck.com)
  • Myeloproliferative neoplasms progress over time as the number of extra cells build up in the blood and/or bone marrow. (merck.com)
  • Myelo refers to the bone marrow, proliferative describes the rapid growth of blood cells and neoplasm describes that growth as abnormal and uncontrolled. (wikipedia.org)
  • An aggressive disease (rapid onset and progression) that occurs primarily in adulthood and is marked by an abnormal increase and accumulation of myeloblasts (immature myeloid cells) in the bone marrow and blood, which leads to impaired hematopoiesis and bone marrow failure. (oncomine.com)
  • Two blast cells, two neutrophilic cells with dumbbell nuclei (pseudo-Pelger cells) and an abnormal eosinophil with five-lobed nucleus. (oncohemakey.com)
  • Frequent eosinophils with myeloid immaturity and blast cells (note prominent nucleoli). (oncohemakey.com)
  • Increased myeloid cells with blast cells. (oncohemakey.com)
  • The white blood cells (leukocytes) are further divided into phagocytes or myeloid (neutrophils, eosinophils, basophils, monocytes) and immunocytes or lymphoid (lymphocytes). (medscape.com)
  • It starts in MYELOID CELLS of the bone marrow, invades the blood and then other organs. (bvsalud.org)
  • In myeloproliferative neoplasms , too many blood stem cells become one or more types of blood cells. (cancerhealth.com)
  • The neoplasms usually get worse slowly as the number of extra blood cells increases. (cancerhealth.com)
  • Chronic myeloproliferative neoplasms sometimes become acute leukemia , in which too many abnormal white blood cells are made. (cancerhealth.com)
  • Other reactive neutrophilic disorders, such as neutrophilic eccrine hidradenitis, are closely related and may represent a spectrum with related pathogenesis. (medscape.com)
  • The prognostic significance of deletion of the long arm of chromosome 20 in myeloid disorders. (atlasgeneticsoncology.org)
  • Elevated WBC, leukocytosis, is seen in response to infection, stress, inflammatory disorders (referred to as reactive leukocytosis), or abnormal production as in leukemia. (medscape.com)
  • bone marrow or peripheral blood blasts of 20 percent or more) and the chronic myeloid disorders (bone marrow or peripheral blood blasts less than 20 percent). (medilib.ir)
  • The chronic myeloid disorders - The chronic myeloid disorders encompass several clinicopathologic entities. (medilib.ir)
  • Myelodysplastic/myeloproliferative neoplasms (MDS/MPN) include disorders that manifest both dysplastic and proliferative features. (medilib.ir)
  • Monitoring of clonal evolution of acute myeloid leukemia identifies the leukemia subtype, clinical outcome and potential new drug targets for post-remission strategies or relapse. (cdc.gov)
  • Trastorno hematopoyético clonal causado por un defecto genético en las CÉLULAS MADRE PURIPOTENTES. (bvsalud.org)
  • They are also at risk of developing secondary acute leukemia from their underlying disorder, as well as from their treatment. (medscape.com)
  • Acute myeloid leukemia (AML) with recurrent cytogenetic abnormalities. (booksca.ca)
  • in turn, each of these categories is classified as either acute or chronic, depending on the proportion of morphologically and immunophenotypically immature precursors (blasts) in the bone marrow or peripheral blood. (medilib.ir)
  • The paradox of proliferative bone marrow together with peripheral blood cytopenias in MDS may be explained by increased intramedullary myeloid precursor cell apoptosis [ 6 ]. (medilib.ir)
  • See "Clinical manifestations and diagnosis of chronic myeloid leukemia" . (medilib.ir)
  • This case report emphasizes that physicians should consider myeloproliferative neoplasms as part of their differential diagnosis when presented with EHPVT. (bvsalud.org)
  • Myeloproliferative neoplasms (MPN), unlike MDS, usually exhibit terminal myeloid cell expansion in the peripheral blood [ 7 ]. (medilib.ir)
  • It is therefore necessary in these cases to recommend a re-biopsy when the only findings are those of chronic inflammation and fibrosis. (basicmedicalkey.com)