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KMID : 0350519950480010301
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Journal of Catholic Medical College
1995 Volume.48 No. 1 p.301 ~ p.311
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Relationship between Morphological Findings of Day 21 Marrow and Outcome After Allogeneic Bone Marrow Transplantation -A Retrograde Analysis of the Correlation Focused on Rejection, Reiapse, and Graft Versus Host Disease-
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Abstract
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Bone marrow examination is one of the most preferred methods to access accurate informations about hematopoietic reconstitution after bonel marrow transplantation(BMT). But only a few reports concerning the histological changes in the bone marrow
after
transplantation have been published. And the histological findings have not been fully discussed as associated variables with clinical events which may influence the outcome of the allogeneic BMT.
To elucidate the early morphological factors related to the clinical outcome following allogeneic BMT, pre- and post-and post-transplant day 21 bone marrow specimens from 83 patients of severe aplastic anemia, chronic myelogenous leukemia, acute
lymphoblastic leukemia, and acute myeloid leukemia were evaluated.
@ES The results were as follows ;
@EN 1. On the biopsied specimen at post-BMT day 21, the hemopoietic cell islands were found as theirnormal topography with or without mixing-up pattern. The more hemopoietic lineages were found, the better outcome followed.
2. Rejection was associated with the following findings of post-BMT day 21 marrow ; the low cellularity, abnormally high G : E ratio(>10 : 1), and in the cases of severe anemia, mastocytosis of the bone marrow.
3. The morbidity of acute acute graft versus host disease was increased when post-BMT day 21 marrow revealed improved fibrosis.
4. There was a tendency that, in patients with leukemia, the relapse rate was increased as the cellularity of post-BMT day 21 marrow was decreased. In patients with chronic myelogenous leukemia, the survival rate was decreased as the pre-BMT
marrow
fibrosis was increased.
These findings suggest that, in examining follow-up day 21 bone marrow after allogeneic BMT, we should not only rule out the graft failure but also observe the cytological details and the patterns of their distribution associated with their
initial
diagnosis, in order to contribute to determining the clinical outcom.
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KEYWORD
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