Diagnostic problems in follow-up bone marrow biopsies of patients treated for acute and chronic leukaemias and MDS.
Bone marrow biopsy evaluation after therapy for hematolymphoid disorders is complex. The difficulties encountered by the pathologist are due to the fact that a variety of heterogenous diseases for which different treatments can be applied have to be considered. Moreover, usually different clinical questions have to be addressed for which different analyses are performed, typically in different laboratories by different investigators. In the present paper, we suggest a systematic, integrative and interdisciplinary approach that includes knowledge of the original diagnosis and of the type of prior therapy, considers treatment effects and a use of standardized response criteria for AML and MDS. Finally, we discuss how to deal with discrepancies between morphological findings in a bone marrow biopsy and the corresponding aspirate.
Dirnhofer
Stephan
S
Institute of Pathology, University Hospital Basel, Basel, Switzerland. sdirnhofer@uhbs.ch
Went
Philip
P
Tichelli
André
A
D000208:Acute Disease; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001706:Biopsy; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology*; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D009196:Myeloproliferative Disorders / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome
D000970:Antineoplastic Agents