Acute bone marrow necrosis caused by streptococcal infection

Terheggen, H. G.; Lampert, F.

doi:10.1007/bf00441899

Cited by 25 publications

(8 citation statements)

References 20 publications

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“…2,3,5-10 Most of these had leukemia (39%), ALL in particular (28.6%), followed by metastatic carcinoma (21.8%), lymphoma (15%), infections (6.8%), 12 and sickle cell disease (6.8%).…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Necrosis

Al-Gwaiz

1997

Ann Saudi Med

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LA Al-Gwaiz, Bone Marrow Necrosis. 1997; 17(3): 374-376 Patchy and focal bone marrow necrosis (BMN) is a relatively common finding in routine bone marrow (BM) biopsy specimens, 2 however, severe BMN is rarely diagnosed in living patients and is more frequently diagnosed in autopsy BM.2-4 BMN has been described in a variety of neoplastic and non-neoplastic diseases. 2,3,[5][6][7][8][9][10] This is a retrospective analysis of consecutive BMN biopsies received over the last five years to assess the incidence of BMN in antemortem biopsies and the diseases associated with it. Materials and MethodsThe bone marrow trephine biopsies received between June 1991 and May 1996 at the Hematology Section, Department of Pathology at King Khalid University Hospital, Riyadh, Saudi Arabia, were retrospectively reviewed. The biopsies were obtained from the posterior iliac spine with a Jamshidi needle and stained with hematoxylin and eosin stain. The biopsies were evaluated for the presence of necrosis. Giemsa-stained BM aspirates obtained from the cases with necrosis were also assessed for evidence of necrosis, e.g., the presence of necrotic cells and necrotic eosinophilic materials for correlation with the biopsy findings.The records of patients with BMN were reviewed for age, sex, diagnosis and the clinical and laboratory features.

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“…2,3,5-10 Most of these had leukemia (39%), ALL in particular (28.6%), followed by metastatic carcinoma (21.8%), lymphoma (15%), infections (6.8%), 12 and sickle cell disease (6.8%).…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Necrosis

Al-Gwaiz

1997

Ann Saudi Med

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“…Wide varieties of conditions are associated with BMN, ranging from infections and sepsis to sickle cell disease, metastatic carcinoma, and hematological malignancies. However, more extensive BMN is more commonly associated with hematological malignancies . BMN has been reported specifically in both acute myeloid (AML) and acute lymphoblastic leukemias (ALL) .…”

Section: Introductionmentioning

confidence: 99%

Bone marrow necrosis in acute leukemia: Clinical characteristic and outcome

et al. 2015

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Background Bone marrow necrosis (BMN) is characterized by infarction of the medullary stroma, leading to marrow necrosis with preserved cortical bone. In reported small series, BMN in hematological malignancies is associated with poor prognosis. We sought to find the impact of BMN on clinical outcome in a relatively larger cohort of patients with acute leukemias. Methods Overall we evaluated 1691 patients; 1051 with acute myeloid leukemia (AML) and 640 with acute lymphocytic leukemia referred to our institution between 2002 and 2013. Patients with AML and ALL were evaluated separately to determine the incidence of BMN, associated clinical features and its prognostic significance. Results At initial diagnosis; BMN was observed in 25 (2.4%) patients with AML and 20 (3.2%) patients with ALL. In AML, BMN was significantly associated with FAB AML M5 morphology (32% vs 10%, p = 0.002). The complete remission (CR) rate in AML with and without BMN was 32% and 59% respectively (p = 0.008). Likewise, CR rate in ALL with BMN was also inferior; 70% vs 92% (p = 0.005). The median overall survival (OS) in AML with BMN was significantly poorer; 3.7 months compared to 14 months without BMN (p= 0.003). Similarly, the median OS in ALL with and without BMN was 61.7 and 72 months respectively (p = 0.33). Conclusion BMN is not a rare entity in AML and ALL, but is infrequent. BMN in AML and in ALL is suggestive of inferior response and poor prognosis.

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“…Malignancy, especially hemopoietic neoplasia, is the most common cause of BMN [5][6][7][8][9][10][11][12][13][14][15]. Sickle cell disease (SCD), infections, sepsis, and drug ingestion are nonmalignant causes of BMN [16][17][18][19][20][21][22][23][24][25]. Some cytokines and new antineoplastic drugs, such as interferon alpha, G-CSF, ATRA, and fludarabine, which are commonly used drugs in hematology-oncology practice, may cause BMN [26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Bone marrow necrosis: Clinicopathologic analysis of 20 cases and review of the literature

et al. 2002

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Bone marrow necrosis (BMN) is a relatively uncommon clinicopathologic entity. The etiology is diverse, and malignancy, especially hematopoietic in origin, is the most common underlying disease of BMN. In this retrospective analysis, cases with BMN were re-evaluated for etiology, histopathologic details, and clinical manifestations. In the last 8 years, 23 cases of BMN were detected among the 1,083 bone marrow (BM) biopsies, and the prevalence was found to be 2.2%. Three of these 23 cases with BMN were children, and 20 cases were in adults. Sixteen of these cases (80%) had underlying malignant disease, and four (20%) had nonmalignant disease. Among the malignant cases, three cases had acute myeloblastic leukemia (AML), four had relapsed Hodgkin's disease (R-HD), one had acute lymphoblastic leukemia (ALL), two had chronic myelocytic leukemia (CML), two had non-Hodgkin's lymphoma (NHL), three had disseminated intravascular coagulation (DIC) associated with metastatic solid tumor, and one had myelodysplastic syndrome/myeloproliferative syndrome (MDS/MPS). Among the nonmalignant cases, two had tuberculosis infection, one had anti-phospholipid syndrome (APS), and one had a history of drug ingestion. The most common symptoms were bone pain, fever, fatigue, and jaundice. The most common laboratory findings were variable and associated with underlying disease, but anemia, leukopenia, thrombocytopenia, and high LDH and alkaline phosphatase levels were detected in the majority of the cases, as was also seen in other series. BMN was graded according to the extent of necrosis in the BM biopsy, and necrosis was extensive in 12 cases, moderate in five cases, and mild in three cases. Increased reticulin was found in 16 cases; four cases had severe, eight had moderate, and four had mild fibrosis, and this was found to be an interesting accompanying finding in BMN. In conclusion malignancy is the most common cause of BMN but some nonmalignant conditions such as tuberculosis and APS may be the underlying cause of BMN. Am.

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Acute bone marrow necrosis caused by streptococcal infection

Cited by 25 publications

References 20 publications

Bone Marrow Necrosis

Bone Marrow Necrosis

Bone marrow necrosis in acute leukemia: Clinical characteristic and outcome

Bone marrow necrosis: Clinicopathologic analysis of 20 cases and review of the literature

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