Bone Marrow Necrosis: Clinical and Pathological Characteristics of 30 Patients

Abstract

Background: Bone marrow necrosis (BMN) affects both stromal tissue and hematopoietic precursors and its prevalence ranges from 0.3–37%, being the hematologic malignancies the most frequent cause. Aim: To describe the clinical and pathological characteristics of 30 patients with BMN diagnosed and treated at our institution. Methodology: We included all adult patients diagnosed during the last 8 years (2000– 2007) via bone marrow aspiration and biopsy. Results: Median age was 44 years (range 14–78); 53.3% were females. 42.2% of the patients died within a month mainly due to adult respiratory distress syndrome (ARDS) and septic shock. Just 5 (16.7%) of them are still alive. In all cases, BMN was of coagulative type, and extense in 23 (76.6%) of the patients. The main symptoms were: bone pain (53%), anemia (53%) and fever (50%), whereas the main underlying diseases were: acute lymphoblastic leukemia (ALL) in 26.7%, non-Hodgkin lymphoma (NHL) in 13.3% and multiple myeloma (MM) in 10% of the patients. Conclusions: BMN is associated to a fatal course and to hematologic malignancies in most of our patients.