Bone marrow necrosis in adult acute leukemia and non-Hodgkin's lymphoma

Leuk Lymphoma. 2000 Aug;38(5-6):627-32. doi: 10.3109/10428190009059283.

Abstract

Bone marrow necrosis is a rare finding in adult patients diagnosed with acute leukemia or non-Hodgkin's lymphoma. Previous reports have suggested that it is associated with a poor prognosis. It remains unclear however, whether improvements in patient care during the last decade have altered patient outcome. In a retrospective review of 581 bone marrow biopsies performed ante mortum on adult patients with acute leukemia or non-Hodgkin's lymphoma, we identified 10 cases of bone marrow necrosis (5 acute myeloid leukemia, 5 non-Hodgkin's lymphoma). Severe bone pain, elevated serum lactate dehydrogenase levels and leukoerythroblastic peripheral blood smears were common presenting features. Despite treating 8 of the 10 patients with curative intent, only 2 patients remain alive and disease-free. This study confirms that bone marrow necrosis in adults with acute leukemia and non-Hodgkin's lymphoma is a rare ante mortum finding and confers a poor prognosis. Whether these patients would benefit from more intensive therapy such as hematopoietic stem cell transplantation remains to be clarified.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Bone Marrow / pathology*
  • Female
  • Humans
  • Leukemia / pathology*
  • Lymphoma, Non-Hodgkin / pathology*
  • Male
  • Middle Aged
  • Necrosis