General responses of the bone marrow to injury

Hematologic responses in a toxicologic setting may be quite complex and may involve both local as well as systemic manifestations of toxicity and/or pharmacologic responses. Direct toxicity to bone marrow can lead to changes such as marrow necrosis, marrow dysplasia, and macrophage hyperplasia. Some toxic compounds can directly stimulate or suppress the development of 1 or more marrow cell lines. The marrow may also respond to injury at distant sites with increased production of various blood cell elements. Accurate interpretation of hematologic responses generally involves integration of peripheral blood data with bone marrow findings as well as toxicologic findings in other organ systems. This manuscript overviews the various marrow changes encountered in toxicologic studies and provides a perspective of how these changes are best approached from an interpretive viewpoint.