title: Localized residual leukaemia in bone marrow of extremities.
abstract: 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.
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Shandong University, Shandong, China. yongliu1958@hotmail.com
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Yifan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Weidong
authors.initials: W
authors.lastname: Hao
authors.forename: Dai
authors.initials: D
authors.lastname: Liu
authors.forename: Ai
authors.initials: A
authors.lastname: Li
authors.forename: Chunyan
authors.initials: C
authors.lastname: Chen
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid