Distribution of Proliferating Bone Marrow in Adult Cancer Patients Determined Using FLT-PET Imaging

Dosimetric predictors of acute haematological toxicity in oesophageal cancer patients treated with neoadjuvant chemoradiotherapy

“…6 Pelvic radiotherapy and chemotherapy are known to be myelosuppressive in patients with cervical and anal cancers, [7][8][9][10][11][12][13] and radiation oncologists have implemented efforts to mitigate the degree of haematological toxicity (HT) associated with these treatments. Given that the thorax contains approximately 35% of the functional BM, 14 irradiation of these thoracic structures could destroy radiosensitive BM stem cells and contribute to HT in patients with EC. However, there is a paucity of data concerning the extent to which thoracic radiation contributes to HT in patients with EC treated with CRT and there are no dose constraints for BM to avoid HT on Quantitative Analysis of Normal Tissue Effects in the Clinic.…”

“…V x indicates the total organ volume percentage exceeding a radiation dose of x (Gy). Results: Greater thoracic vertebrae and rib irradiation doses, including mean vertebral dose (MVD), thoracic vertebrae V 5-30 (TVV ), mean rib dose and rib V [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] , were associated with increased leukopenia (grade $ 3) risk. Additional BM sites (sternum, scapulae and clavicles) did not influence HT.…”

Allogeneic cell transplant expands bone marrow distribution by colonizing previously abandoned areas: an FDG PET/CT analysis

“…Regardless of its source, transplanted BM showed intense glucose consumption in long bone shafts, which in normal adults are usually occupied by metabolically inert tissues. 1,10,13 These findings suggest that in the setting of allogeneic BM transplantation, volumetric and metabolic parameters of ABM are regulated by at least partially different homeostatic pathways. Furthermore, volumetric expansion could be a key feature to meet the hugely increased hematopoietic workload and to achieve the reconstitution of the hematopoietic system in the shortest possible time.…”

“…1 Accordingly, regardless of the sampling site, cellular and molecular analyses based on bone marrow (BM) aspiration or biopsy represent the standard for diagnosis, staging, and response assessment in the vast majority of blood disorders. 2 This notion implies that any modification of BM composition occurs almost synchronously in every BM district and that the circulation of a limited number of hematopoietic stem cells (HSCs) accounts for the tight adjustment of hematopoiesis to blood cell demand.…”

“…5 Conversely, in adult humans, only a proportion of BM spaces are occupied by functioning marrow. 1 Some simple mathematical considerations might help to better define the importance of volumetric availability in the context of HSC turnover: overall, BM produces an average of 10 11 granulocytes and 10 11 erythrocytes per day. 6 Because volumes of these cells are 200 to 300 fL and 90 fL, 7,8 respectively, this activity roughly corresponds to a BM cell output averaging 30 to 50 mL per day.…”