title: Extent and time course of morphological changes of bone marrow induced by granulocyte-colony stimulating factor as assessed by magnetic resonance imaging of healthy blood stem cell donors.
abstract: The aim of this study was to assess the time course and extent of signal alterations of red bone marrow after short-term stimulation by recombinant human granulocyte-colony stimulating factor (rHuG-CSF) in healthy peripheral blood stem cell donors using magnetic resonance imaging (MRI) at low-field strength. Twelve healthy blood stem cell donors without evidence of bone marrow disorders were prospectively investigated and underwent four MRI studies of their lumbar spine. Sagittal T1- and T2-weighted spin-echo sequences and a gradient-echo (GE) sequence with an echo time for out-of-phase imaging were performed prior to rHuG-CSF application (baseline MRI), on the day of first stem cell harvest (after 70 microg/kg body weight rHuG-CSF, second MRI) followed by two studies 9-18 days (median 14.5 days, third MRI) and 26-48 days (median 39.5 days, fourth MRI) after discontinuation of rHuG-CSF application. Baseline MRI showed normal marrow signal in all patients. The second MRI revealed a decrease of quantified bone marrow signal relative to nucleus pulposus in T1- and T2-weighted images and an increase of relative signal in out-of-phase GE sequences. The greatest changes of relative marrow signal were observed at the third MRI. Compared to baseline MRI, relative marrow signal was diminished by 12% in T1-weighted images and increased by 59% in GE sequences, consistent with a rise in marrow cellularity simulating diffuse marrow disease. At the fourth MRI quantified relative marrow signal returned to baseline levels in all sequences. In healthy individuals rHuG-CSF application leads to significant signal changes of bone marrow in lumbar vertebra that are maximal about 2 weeks after discontinuation of rHuG-CSF application. In patients with underlying marrow disorders who receive hematopoietic growth factors during treatment, these changes should not be confused with disease progression.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Freiburg, Germany. alca@mrs1.ukl.uni-frieburg.de
authors.forename: C
authors.initials: C
authors.lastname: Altehoefer
authors.forename: H
authors.initials: H
authors.lastname: Bertz
authors.forename: N A
authors.initials: NA
authors.lastname: Ghanem
authors.forename: M
authors.initials: M
authors.lastname: Langer
mesh_terms: D000328:Adult; D001854:Bone Marrow Cells / Q000187:drug effects*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins; D013997:Time Factors; D014019:Tissue Donors
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor