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©2013 UpToDate ® Print Email Bone marrow findings in myeloproliferative variants of hypereosinophilic syndrome (HES) The bone marrow biopsy sections presented are from two representative patients with hypereosinophilic syndrome with (A-C) and without (D-F) elevated serum tryptase levels stained with hematoxylin and eosin (A, D), antitryptase antibody (B, E), and antireticulin antibody (C, F). Although the bone marrow biopsy specimens from both patients show a dramatic increase in eosinophils and myeloid precursors (A, D), only the specimen from the patient with elevated serum tryptase shows marked hypercellularity (A), atypical spindle-shaped mast cells (B), and reticulin fibrosis (C). This research was originally published in Blood. Klion AD, Noel P, Akin C, et al. Elevated serum tryptase levels identify a subset of patients with a myeloproliferative variant of idiopathic hypereosinophilic syndrome associated with tissue fibrosis, poor prognosis, and imatinib responsiveness. Blood 2003; 101:4660. Copyright © 2003 American Society of Hematology.