Alcoholic Dyshaematopoiesis: Morphological Features of Alcohol-Induced Bone Marrow Damage in Biopsy Sections Compared with Aspiration Smears

Abstract

We investigated trephine biopsies from 118 alcoholic patients in order to establish whether or not the known alcohol-induced alterations seen in smears are seen in bone marrow tissue sections, and whether new features might emerge, which could be suitable for defining the histological picture of a condition to be known as ‘alcoholic dyshaematopoiesis’. The main changes involve erythropoiesis and iron metabolism. They can be attributed in part to destabilization of the red cell membrane. While these alterations are clearly visible in tissue sections, aspiration smears are needed to detect other features, especially ring sideroblasts.

Erythroid proliferations in myeloid neoplasms

“…In MDS patients who respond to erythropoietin treatment, the erythroblast proportion is often decreased rather than increased, in parallel to decreased overall bone marrow apoptosis and recovered more effective erythropoiesis [51,52]. Ring sideroblasts (even if they comprise b15% of erythroid elements) can be a helpful feature to suggest "true" erythroid dysplasia, provided nonneoplastic causes of ring sideroblasts can be excluded (alcohol ingestion [53]; antituberculosis antibiotics and some other drugs [54]; toxins such as benzene or lead, copper deficiency, or zinc excess [55,56]; pregnancy [57,58]; congenital sideroblastic anemia [59]; and posttreatment for cancer with cytotoxic agents [60,61]). …”

Transcriptional and Epigenetic Regulation of Monocyte and Macrophage Dysfunction by Chronic Alcohol Consumption

“…AUD patients suffer from blood cell disorders including lymphopenia, anemia, and thrombocytopenia (199)(200)(201)(202)(203). In addition, almost half of alcoholics have foamy macrophages due to the storage of alcohol-induced lipids in the cytoplasm (204). Hemostasis is also perturbed in ALD, due to alcohol's effects on the platelets leading to an increased risk of disseminated intravascular coagulation (205).…”