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Bone marrow necrosis
A M Janssens1, F C Offner, W Z Van Hove
1University Hospital Ghent, Department of Hematology, Ghent, Belgium.
Cancer
|April 13, 2000
Summary
Bone marrow necrosis (BMN) is a rare condition often linked to underlying cancer. Early diagnosis and supportive care are crucial for managing symptoms and complications until the primary disease is treated.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Bone marrow necrosis (BMN) is a poorly understood clinicopathologic entity.
- Despite being described over 50 years ago, its prevalence and characteristics remain largely unknown in the medical community.
Purpose of the Study:
- To determine the prevalence, clinical presentation, and diagnostic utility of BMN.
- To investigate the underlying disease associations of BMN.
- To understand the management and prognosis of BMN.
Main Methods:
- An extensive literature search was conducted.
- Included were 240 cases of extensive bone marrow necrosis diagnosed during life.
Main Results:
- The most common symptoms were bone pain (75%) and fever (68.5%).
- Frequent hematologic abnormalities included anemia (91%), thrombocytopenia (78%), and a leukoerythroblastic picture (51%).
- Malignancy was identified in 90% of patients, with elevated lactate dehydrogenase and alkaline phosphatase levels observed in nearly 50%.
Conclusions:
- BMN results from hypoxemia due to microcirculatory failure.
- A high association with malignancy necessitates a thorough search for cancer when BMN is diagnosed.
- Pancytopenia and embolic events are significant complications requiring supportive management; normal hematopoiesis can be restored upon resolution of necrosis.