Bone Marrow Necrosis: Frequency and Clinicopathological Findings in Marrow Biopsies

Background and Objectives: Bone marrow necrosis (BMN) is a rare and ominous complication of wide variety of diseases including hematologic malignancy. This study was performed to identify frequency and the underlying associated diseases of marrow necrosis. Materials and Methods: In this descriptive study, totally 850 bone marrow trephine biopsies related to living patients at the Pathology Department of Urmia Imam Hospital from March 1998 to January 2008, were retrospectively reviewed. The reviews included clinical and laboratory findings from files of the patients. Results: Eight cases of bone marrow necrosis were found. Frequency was 0.94 percent. Ages of the patients were between 18 and 85 years, and four of them were female. Prominent symptoms of the patients were bone pain, fever, fatigue, and jaundice. The most common laboratory findings were anemia, cytopenia, elevated lactate dehydrogenase (LDH), and alkaline phosphatase (ALP). Underlying diseases of bone marrow necrosis in our patients includes systemic lupus erythematosus, multiple myeloma, metastatic gastric cancer, acute myeloid leukemia (M4), hairy cell leukemia, lymphoma, chronic myeloid leukemia and sepsis. Conclusion: Our findings suggest that the conditions associated with BMN are varied and malignancy remains common. In cases presented with pyrexia, bone pain, pancytopenia, elevated LDH and ALK, marrow necrosis must be thought. Although prognosis is very bad, supplementary therapy, in addition to the underlying disease must be performed.