Bone marrow necrosis in bone marrow transplantation: the role of MR imaging

Abstract

Summary:We describe an ALL patient who developed extensive bone marrow necrosis at the time of relapse 2 months after allogeneic bone marrow transplantation from an HLA-identical sibling. The excruciating and diffuse bone pain, fever and precipitous drop in peripheral blood counts were characteristic. This case illustrates the importance of repeat bone marrow biopsies for the diagnosis of disease relapse and the potential application of MR imaging in the assessment of patients with bone marrow necrosis.

Bone marrow necrosis in pediatric malignancies: 10‐Year retrospective review and review of literature

“…MRI has been widely used to detect bone abnormalities in multiple disease entities, including hematologic malignancies 14 . Previously described BMN MRI findings include fluid‐filled necrotic lesions, hyperintense lesions, and other findings with similar appearance to periarticular avascular necrosis 15,16 . While not typically part of the diagnostic workup, due to atypical presentations of patients in our cohort, MRIs were obtained in many patients demonstrating abnormal bone signal corresponding to areas of BMN.…”

Bone marrow necrosis associated with relapse of acute myelogenous leukemia following unrelated hematopoeitic stem cell transplantation using an immunoablative regimen

“…To date, there are only two case reports of bone marrow necrosis occurring in patients following stem cell transplantation [8,9]. Our patient differs from them because of the conditioning regimens employed.…”

“…The increased recipient DNA in the bone marrow when compared to the peripheral blood by VNTR analysis may be explained by the sample having been taken from a site of increased leukemic in®ltration in the bone marrow. The value of MR imaging of the spine and pelvis in this unique sub-set of patients has been well emphasized in the literature [8]. This technique not only helps to assess the extent of bone marrow necrosis, but also allows guided bone marrow aspirate and biopsy at non-necrotic sites.…”