Bone marrow necrosis in acute leukemia

2 patients with premortem marrow necrosis in acute leukemia are discussed. A review of the course of each patient plus those in the literature suggests that premortem marrow necrosis may not be a poor prognostic sign in acute lymphoblastic leukemia but generally precedes a prolonged and fatal pancytopenia in acute myelogenous leukemia. The technetium-99m rhenium sulfur colloid marrow scan was found to be of value in assessing the extent and degree of necrosis of the marrow as well as in documenting and predicting marrow recovery following chemotherapy.