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Aseptic bone/bone marrow necrosis in leukaemia.

A Vesterby, O Myhre Jensen

    Scandinavian Journal of Haematology
    |September 1, 1985
    PubMed
    Summary

    Aseptic bone necrosis (ABN) occurred in 6.5% of leukemia patients, often affecting the femur. Ischemia due to vascular obstruction is a potential cause of this bone complication.

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    Area of Science:

    • Oncology
    • Pathology
    • Radiology

    Background:

    • Aseptic (avascular) bone/bone marrow necrosis (ABN) is a recognized complication in leukemia patients.
    • The frequency and specific manifestations of ABN in leukemia require further elucidation.

    Purpose of the Study:

    • To determine the frequency and characteristics of aseptic (avascular) bone/bone marrow necrosis (ABN) in leukemia patients.
    • To investigate the clinical and pathological findings associated with ABN in this patient cohort.

    Main Methods:

    • Retrospective analysis of 21 leukemia patients diagnosed with ABN over a 14-year period.
    • Review of autopsy findings, including gross pathology and post-mortem X-ray examinations.
    • Correlation of pathological findings with clinical data, including symptoms and laboratory results.

    Main Results:

    • ABN was identified in 6.5% of autopsied leukemia patients, with the highest incidence in acute lymphoblastic leukemia (ALL).
    • Bone pain was reported in 38% of patients; X-ray findings were positive in 43% of symptomatic cases.
    • Autopsy revealed ABN predominantly in the femur, with evidence of recent necrosis, fibroblast proliferation, and early bone formation in most cases.

    Conclusions:

    • Aseptic (avascular) bone/bone marrow necrosis is a significant, though infrequent, complication in leukemia patients.
    • The pathogenesis of ABN in leukemia is not fully understood, but vascular obstruction leading to ischemia is a likely contributing factor.

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