Differences in Distribution of Erythropoietic and Reticuloendothelial Marrow in Hematologic Disease

Abstract

Although reticuloendothelial cells are an invariable component of normal marrow, the distribution of phagocytic acitivity may or may not correspond to the distribution of erythropoietic activity in the presence of disease affecting the marrow. A direct comparison of the distributions of reticuloendothelial marrow (using Tc99m-sulfur colloid) and erythropoietic marrow (using Fe52) in patients receiving treatment for various diseases affecting the bone marrow has been made. In the presence of hematologic disease, the correlation between the distributions of these two marrow functions has varied from identical to totally dissimilar. Unless one is studying normal subjects, knows a priori that marrow composition is normal, or is specifically studying the reticuloendothelial component of the marrow, one must be cautious in equating marrow distributions obtained with colloidal material with erythropoietic marrow distribution.

99mTc‐Nanocolloid Bone Marrow Scintigraphy in Prostatic Cancer

“…with only 5% of human serum albumin millimicrospheres (Hotze et at., 1986), 3.5% of Technetium-99m antimony colloid and 0.8% of Technetium-99m sulphur colloid (Martindale et al, 1980); the remainder of the injected dose is taken up by the liver and spleen (Hotze et al, 1986). The distribution of the reticuloendothelial and haemopoietic components of bone marrow varies in some haematological diseases (Van Dyke et al, 1967;Fordham and Ali, 1981). However, it is generally accepted that metastatic disease affects both components similarly, although there is little supportive evidence.…”

An analysis of prognostic factors in preleukemia: Interest of bone marrow scintigraphy

“…The colloids labeled with Technetium are taken up by the macrophages and visualize the hemopoietic medullary bed [19]. Indium transferrin, used for lack of available iron-52, of short period and high cost, has an essentially erythropoietic uptake, but also has a small uptake on immature granulopoietic cells who possess transferrin receptors [20].…”

The radiocolloid bone marrow scan in malignant disease

“…By age 25, the adult pattern has been assumed with functioning marrow contained in the axial skeleton, vertebrae, ribs, scapulae, upper one fourth of the humerus, and upper one third of the femur. The amount of marrow in t h e skulIis quite variable, even in thenormalindividual (Van Dyke et al, 1967). Figure 1 shows the normal adult distribution of T C~~' " concentrated within the active marrow.…”

“…The distribution of the R E cell and erythron are identical in normal man (Nelp and Bower, 1969), but under the stress of marrow disease these two components may occasionally be disassociated (Van Dyke et al, 1967). For this reason, the relationship of hematopoietic function and the radiocolloid scan of diseased marrow must be interpreted with caution.…”