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Pelvic magnetic resonance imaging after bone marrow harvest--a retrospective study in 50 unrelated marrow donors
F Kroschinsky1, T Kittner, S Mauersberger
1University Hospital Dresden, 1st Medical Department, Dresden, Germany. kroschinsky@mk1.med.tu-dresden.de
Abstract:
A total of 50 unrelated marrow donors were examined by pelvic magnetic resonance imaging (MRI) to investigate the morphological sequelae of bone marrow harvesting (BMH). Signal increase in T2-weighted sequences and contrast media enhancement in T1 sequences at the operative sites were found as typical MRI morphology 4 weeks after harvest (group A, n=16), corresponding to edema, hyperemia and proliferative activity. Although tissue repair was completed in the majority of donors 1 year after BMH, about 36% of donors in group B (n=16) had abnormal findings. These included a persistence of the 'acute injury' signal pattern (2/16, 12%), and signal alterations due to fatty marrow conversion (4/16, 24%). The proportion of MRI abnormalities increased to over 70% in two-time donors (group C, n=11), which might indicate a cumulation of tissue damage after repetitive harvests. If donors had experienced prolonged discomfort after BMH (group D, n=7), MRI revealed pathological signals in 86%. In conclusion, the MRI morphology reflects the pathophysiological reactions after BMH, including inflammation and tissue repair. A further prospective evaluation in a larger number of donors is necessary to confirm these results and to identify the factors which influence the extent and duration of tissue damage.
Insights
Magnetic resonance imaging (MRI) reveals bone marrow harvesting (BMH) can cause persistent tissue changes. Some donors show abnormalities up to a year later, with increased risk after multiple harvests or prolonged discomfort.
Area of Science:
- Radiology
- Hematology
- Surgical Pathology
Background:
- Bone marrow harvesting (BMH) is a procedure for stem cell transplantation.
- Understanding the long-term effects of BMH on donor tissue is crucial for donor safety and care.
Purpose of the Study:
- To investigate the morphological sequelae of bone marrow harvesting (BMH) using pelvic magnetic resonance imaging (MRI).
- To assess the impact of time, repeat harvests, and donor discomfort on post-harvest tissue changes.
Main Methods:
- Pelvic MRI was performed on 50 unrelated marrow donors at various time points post-harvest.
- Donors were categorized into groups based on time since harvest, number of harvests, and presence of prolonged discomfort.
Main Results:
- Four weeks post-harvest, typical MRI findings included edema and hyperemia at operative sites.
- One year post-BMH, 36% of donors exhibited abnormal MRI findings, including persistent 'acute injury' patterns and fatty marrow conversion.
- Over 70% of two-time donors and 86% of donors with prolonged discomfort showed pathological MRI signals.
Conclusions:
- MRI morphology accurately reflects pathophysiological reactions, including inflammation and tissue repair, following BMH.
- Repetitive harvests and prolonged discomfort may be associated with cumulative tissue damage.
- Further prospective studies with larger donor cohorts are needed to confirm findings and identify influencing factors.
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