Localized residual leukaemia in bone marrow of extremities.
OBJECTIVE
This study aimed to confirm localized residual leukaemia in the abnormal expanded peripheral bone marrow (e-PBM) of the extremities using Tc-sulfur colloid imaging and bone marrow aspirations.


METHODS
Whole-body bone marrow scintigraphy was performed in 420 adult and 48 childhood leukaemia patients using Tc-sulfur colloid (370 MBq). Central bone marrow (CBM) from the iliac crest and e-PBM from the proximal epiphyseal line of the tibia were aspirated at the time of routine examination and compared.


RESULTS
The expansion rate of the PBM in the non-remission stage of acute leukaemia was 73.1%, and it decreased to 38.4% in the complete remission stage. The most common site of PBM expansion was the epiphysis of the knee joint (74.5%). Cytological examination of the e-PBM at the complete remission stage revealed 30.9% localized residual leukaemia. The complete remission period (69+/-23 days) of PBM expansion was significantly greater than that of CBM depletion (43+/-31 days) (P<0.01). Localized residual leukaemia of the e-PBM could not be detected in the childhood acute leukaemia patients and in the patients without e-PBM. The difference in the relapse rate and time was statistically significant between patients with e-PBM (29.1%) and without e-PBM (3.5%) (P<0.01).


CONCLUSIONS
These findings suggest that induction chemotherapy does not always have a synchronous and parallel effect on CBM and PBM. The e-PBM is less sensitive to chemotherapy and can easily exist in localized residual leukaemia. The detection of residual leukaemia in the e-PBM by bone marrow scintigraphy is very important in the treatment of leukaemia.
Liu
Yong
Y
Department of Nuclear Medicine, The Second Hospital of Shandong University, Shandong, China. yongliu1958@hotmail.com
Zhang
Yifan
Y
Hao
Weidong
W
Liu
Dai
D
Li
Ai
A
Chen
Chunyan
C
D000293:Adolescent; D000328:Adult; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D005121:Extremities / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000517:prevention & control; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013671:Technetium Tc 99m Sulfur Colloid
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid