Analysis and Clinical Characteristics of 23 Cases of Bone Marrow Necrosis

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2021-04, Vol.21 (4), p.e356-e364
• Main Authors: Chen, Ruge, Wu, Jun, Yang, Jilong, Wei, Cong, Liang, Dan, Du, Jingwen, Li, Yuhua, Liu, Qifa, Zhang, Yu, Deng, Lan
• Format: Article
• Language: English
• Subjects: Acute B lymphocytic leukemia; Acute myeloid leukemia; Adolescent; Adult; Aged; Biopsy; Bone Marrow - pathology; Child; Child, Preschool; Clinical analysis; Female; Follow-Up Studies; Hematological malignancy; Humans; Incidence; Leukemia, B-Cell - blood; Leukemia, B-Cell - complications; Leukemia, B-Cell - diagnosis; Leukemia, B-Cell - mortality; Male; Middle Aged; Necrosis - blood; Necrosis - diagnosis; Necrosis - epidemiology; Necrosis - etiology; Prognosis; Retrospective Studies; Risk Assessment - statistics & numerical data; Survival Analysis; Time Factors; Young Adult
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/j.clml.2020.12.001

Bone marrow necrosis (BMN) is a rare secondary disorder of many discrepant neoplastic processes. The etiology is diverse, and malignancy is the most common background disease. Between 2005 and 2019, a total of 23 cases of BMN were detected and analyzed at Zhujiang Hospital and Nanfang Hospital. In our study, the 40-60-year-old age group was the one with the highest incidence of BMN (n = 12, 52.2%). The background diseases of patients with BMN varied. Eighteen (78.3%) of 23 patients were diagnosed with hematologic diseases at the same time, most of which were acute B lymphocytic leukemia (n = 8, 34.8%). The complete blood count of these 23 patients noted a decrease in hemoglobin (100%), a decrease or increase in white blood cells and neutrophils, and thrombocytopenia (78.3%). The levels of lactate dehydrogenase (> 300 U/L) and serum ferritin (> 500 μg/L) were elevated in all patients, and 16 (94.1%) of 17 patients presented with increased d-dimer levels. The 2-week cumulative survival and 2-year cumulative survival of patients with BMN were 56.5% and 47.4%, respectively. The mortality probability within 2 weeks was 43.5%, and the adjusted mortality probability was 26.7% within 2 weeks to 2 years, indicating that patients with BMN had the greatest risk of death within 2 weeks. BMN patients with B lymphocytic leukemia as the background disease had a better prognosis than those with other background diseases. BMN of unknown etiology may have an extremely poor prognosis. Therefore, diagnosing the background disease plays an important role in the treatment of BMN. Bone marrow necrosis (BMN) is a rare secondary event of many discrepant neoplastic processes. Between 2005 and 2019, 23 cases of BMN were detected and analyzed at Zhujiang Hospital and Nanfang Hospital. BMN of unknown etiology may have an extremely poor prognosis, so diagnosing the background disease plays an important role in the treatment of BMN.