Histopathology of bone marrow after allogeneic bone marrow transplantation for chronic myeloid leukaemia

The histopathology of bone marrow after allogeneic bone marrow transplantation for chronic myeloid leukaemia (CML) was studied in 20 bone marrow biopsy specimens from 14 patients. Biopsies were performed at day 30 post-transplantion (5 biopsies), between day 90 and day 100 (14 biopsies), and one year post-transplantation (1 biopsy). Eight biopsies taken at day 30 post-transplantation for lymphoproliferative disorder were studied as controls. Granulopoiesis was predominant in all day 30 bone marrows in patients treated for CML. In 2 cases, rejection was suspected because of marrow hypoplasia at day 30: one case developed acute leukaemia soon after persistant hypoplasia at day 90 while the evolution of the other case was good. Two day 30 biopsies showed granulocytic hyperplasia but follow-up proved complete remission of CML. Thus, in our series, early biopsies at day 30 did not have any prognostic value. Twelve cases at day 90-100 showed little modifications, such as minor dyserythropoiesis and dysmegakaryopoiesis. One case showed granulocytic hyperplasia at day 100 but bone marrow was normal one year later and the patient in complete remission. The haematopoietic reconstitution after allogeneic bone marrow transplantation may present a transient granulocytic hyperplasia that must not be diagnosed as a persistence of CML.