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PubMed1995

A diagnostic workstation for neoplastic bone marrow diseases: evaluation on 526 cases.

The diagnostic accuracy of a workstation for neoplastic bone marrow pathology was evaluated on 526 cases from two institutions. The workstation consists of knowledge-based systems for peripheral blood analysis, flow cytometry immunophenotyping, and bone marrow morphology, linked together by a relational database. The "gold standard" diagnosis was established by complete agreement among three hematopathologists after independent review of the data from each case. The workstation's diagnosis agreed with the "gold standard" in 515 cases (97.9%). In six of the 11 diagnostic errors, the bone marrow module could not reach a final diagnosis. The five misclassifications would not have resulted in a change of therapy for the patient. The institutional diagnosis of record agreed with the gold standard in 462 cases (87.8%). The results indicate that the workstation is capable of high-quality, reproducible, multiparameter interpretive reporting.

Acute Disease↗
PubMed2000

Systemic aspects of allergic disease: bone marrow responses.

In patients with allergic diseases, allergen provocation can activate a systemic response that provokes inflammatory cell production by the bone marrow. After release and differentiation of progenitor cells, eosinophils, basophils, and mast cells are typically recruited to tissues in atopic individuals. An understanding at the molecular level of the signaling process that leads to these systemic responses between the target organ, especially the airways, and the bone marrow may open up new avenues of therapy for allergic inflammatory disease. Studies that support the critical involvement of the bone marrow in the development of eosinophilic inflammation of the airways point out the systemic nature of these conditions and their potential for biologic intervention. Hemopoietic events that originate in the bone marrow are potential targets of long-term therapy for rhinitis and asthma. For example, the "beneficial" systemic activity of cortico-steroids through modulation of hemopoietic mechanisms and inflammatory cell recruitment to the airways is essential for the optimal treatment of both upper and lower airway inflammation.

Animals↗
PubMed1985

Histidinol-mediated enhancement of the specificity of two anticancer drugs in mice bearing leukemic bone marrow disease.

The possibility was investigated that L-histidinol-anticancer drug combinations may provide increased tumor cell eradication and eliminate in vivo bone marrow toxicity of proliferation-dependent anticancer agents in animals bearing an established, intrafemoral bone marrow disease. It was previously demonstrated that L-histidinol, a structural analogue of the essential amino acid L-histidine, improves the specificity of cytarabine (ara-C) and 5-fluorouracil (FUra) in DBA/2J mice bearing intraperitoneal L 1210 leukemia. Accordingly, DBA/2J mice were given iv injections of 1 X 10(6) L1210 leukemia cells 3 days before histidinol-anticancer drug treatments. During the postinjection, pretreatment interval, injected tumor cells populated the femoral marrows, shown by clonogenic assays and flow cytometric analyses. Following various drug treatments, quantitative and selective survival assays were performed of normal femoral cells and of clonogenic L1210 leukemia cells isolated from the femurs of treated mice. These experiments demonstrated that L-histidinol not only protected the marrow cell population from both ara-C and FUra, but also increased significantly the toxicities of these agents for the intrafemoral tumor cells. Thus L-histidinol mediates a substantial increase in the specificities of ara-C and FUra in mice bearing an established bone marrow leukemic condition.

Animals↗
PubMed1989

Magnetic resonance imaging and magnetic resonance spectroscopy of bone tumors and bone marrow disease.

The authors have made use of an integrated magnetic resonance imaging/spectroscopy (MRI/MRS) examination to study seven patients with a variety of bone tumors. The spatial localization method used in the 31P portion of the examination was surface coil localization and a one-dimensional chemical shift imaging method (3 cases). The authors found that the precision of spatial localization was critical in many of these cases, since most of these bone tumors were surrounded by muscle tissue that contained high concentrations of phosphocreatine (PCr). For this reason, they suggest that the metabolite ratios should be referenced to the adenosine triphosphate (beta-NTP) resonance rather than PCr. The phosphate monoester (PME) to beta-NTP ratio was elevated as compared with normal muscle in all of the bone tumors studied. The authors found that all of these tumors exhibited pHs between 7.0 and 7.2, which are similar to the values found for normal muscle. They also show the feasibility of using a line-selective proton chemical shift imaging sequence with high spatial resolution for investigating changes in the fatty composition of bone marrow. This method is illustrated in an example of a patient with advanced avascular necrosis in the femoral heads.

Adolescent↗
PubMed1993

Magnetic resonance imaging of diffuse bone marrow disease.

MR is a highly sensitive alternative to plain films, CT, and radionuclide studies for the imaging of normal and abnormal marrow and can characterize differences between fatty, fibrotic, cellular, hypercellular, and hemosiderotic marrow. MR is helpful in depicting the extent of disease and has been a useful method to follow the clinical course of many disorders. It has been found to be particularly useful in explaining the unrepresentative biopsy, as the distribution of many diseases is frequently heterogeneous as exemplified by the mixed fatty and cellular patterns of aplastic anemia, myeloma, lymphoma, and skeletal metastases. Patterns of cellular and fatty marrow in the epiphysis and apophysis after marrow reconversion were not completely understood prior to the introduction of MR scanning. Because it has the advantage of imaging the entire bone marrow compartment (unlike the situation with biopsy on aspiration), MR allows a better understanding of the distribution of skeletal disease.

Bone Marrow↗