Quantitative assessment of erythropoiesis in bone marrow expansion areas using ⁵²Fe

Abstract

Quantitative 52Fe scans were performed in 180 patients. Expansion of bone marrow was observed in 70. This bone marrow expansion was a nearly constant feature in haemolytic anaemia and in sideroblastic anaemia. It occurred in a third of the patients with myelofibrosis. In patients with polycythaemia rubra vera, expansion was noticed in only two out of seven. Erythropoiesis in expansion areas occurred despite persistence of fat in the iliac crest bone marrow biopsy. It could exist with a slight increase in erythropoiesis and might develop only after a long period of erythropoietic stimulation. Increased marrow activity can take place without erythropoietic expansion in long bones. The fraction of iron uptake in expansion areas did not exceed a third of total marrow iron uptake. With increasing erythropoiesis, the increase in iron uptake in expansion areas was less marked than the increase in the central areas. Erythropoiesis in expansion areas was usually not of major quantitative importance but could nevertheless reach the erythropoiesis of a normal adult.

Radionuclide imaging of bone marrow disorders

“…It has a half-life of 45 days, and therefore imaging is of low quality with a high radiation dose. Bone marrow expansion has been demonstrated in patients with chronic HA (not acute HA), MF and, on rare occasions, PV [24]. However, the disadvantages mentioned above and the limited availability of the isotope and PET facilities have precluded its widespread use.…”