Ringed sideroblasts: a frequent observation after bone marrow transplantation

Area of Science:

• Hematology
• Transplantation Medicine
• Pathology

Background:

• Dyserythropoiesis is a frequent complication following bone marrow transplantation.
• The presence and significance of ringed sideroblasts (RS) post-transplant require further investigation.

Purpose of the Study:

• To evaluate the prevalence of ringed sideroblasts (RS) in post-bone marrow transplant patients.
• To compare the sensitivity of a combined silver and Perls' Prussian blue stain versus Perls' stain alone for RS detection.

Main Methods:

• Utilized a combined silver and Perls' Prussian blue stain on bone marrow aspirate sections from 39 post-transplant patients.
• Compared findings with pre-transplant samples from 11 patients and normal marrows from 5 individuals.
• Included allogeneic (28) and autologous (11) transplant recipients.

Main Results:

• Ringed sideroblasts (RS) were detected in 87% (34/39) of post-transplant marrows using the modified silver stain.
• Only 19% (7/36) of these marrows showed RS with Perls' stain alone.
• RS were rare in pre-transplant and normal marrows, indicating they are a post-transplant phenomenon.

Conclusions:

• Ringed sideroblasts (RS) are a common finding in bone marrow post-transplantation, persisting beyond the typical reconstitution period.
• The modified silver stain is significantly more sensitive for detecting RS than Perls' Prussian blue stain alone.
• The presence of RS post-transplant is likely a feature of dyserythropoiesis and not directly related to pre-transplant pathology or treatment.