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Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018
[3 cases of bone marrow necrosis in acute leukemia]
J L Montemayor-Montoya1, R E De León-Cantú, D Gómez-Almaguer
1Departamento de Medicina Interna, Hospital Universitario de la UANL, Monterrey, N.L., México.
Abstract:
Bone marrow necrosis (BMN) is mostly diagnosed at postmortem examination. It has been observed in association with acute leukemia and other malignant diseases. We report here BMN in two patients with acute myeloid leukemia (AML) and one with acute lymphocytic leukemia (ALL) in whom the diagnosis was made while alive. Two patients died because of intracranial bleeding. One with AML (M5) developed BMN one week after he was treated with a second course of chemotherapy: he had a complete recovery and remains in remission almost five years after the diagnosis. We conclude that antemortem diagnosis of BMN is technically difficult, but as it is not always associated to a fatal prognosis, an early diagnosis and vigorous supportive therapy should be attempted.
Insights
Bone marrow necrosis (BMN), a condition often diagnosed postmortem, can occur in patients with acute leukemia. Antemortem diagnosis is challenging but possible, offering a chance for early intervention and improved outcomes.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Bone marrow necrosis (BMN) is a rare clinicopathological entity.
- It is frequently associated with hematological malignancies, particularly acute leukemia.
- Diagnosis is typically made during postmortem examination.
Observation:
- This report details three cases of BMN diagnosed antemortem.
- Two patients had acute myeloid leukemia (AML), and one had acute lymphocytic leukemia (ALL).
- Two patients succumbed to intracranial hemorrhage; however, one AML patient achieved complete remission and long-term survival.
Findings:
- Antemortem diagnosis of BMN in leukemia patients is feasible, though challenging.
- BMN is not invariably linked to a fatal outcome.
- Chemotherapy and supportive care may lead to recovery.
Implications:
- Highlights the possibility of antemortem diagnosis for BMN.
- Suggests that early diagnosis and aggressive supportive management can improve prognosis.
- Underscores the need for increased awareness among clinicians regarding BMN in leukemia patients.
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