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Type: Journal article
Title: Bone marrow recovery by morphometry during induction chemotherapy for acute lymphoblastic leukemia in children
Author: Nguyen, T.
Melville, A.
Nath, S.
Story, C.
Howell, S.
Sutton, R.
Zannettino, A.
Revesz, T.
Citation: PLoS One, 2015; 10(5):e0126233-1-e0126233-10
Publisher: Public Library of Science
Issue Date: 2015
ISSN: 1932-6203
Statement of
Tuong-Vi Nguyen, Anna Melville, Shriram Nath, Colin Story, Stuart Howell, Rosemary Sutton, Andrew Zannettino, Tamas Revesz
Abstract: Bone marrow architecture is grossly distorted at the diagnosis of ALL and details of the morphological changes that accompany response to Induction chemotherapy have not been reported before. While marrow aspirates are widely used to assess initial response to ALL therapy and provide some indications, we have enumerated marrow components using morphometric analysis of trephine samples with the aim of achieving a greater understanding of changes in bone marrow niches. Morphometric analyses were carried out in the bone marrow trephine samples of 44 children with ALL, using a NanoZoomer HT digital scanner. Diagnostic samples were compared to those of 32 control patients with solid tumors but without marrow involvement. Samples from patients with ALL had significantly increased fibrosis and the area occupied by bony trabeculae was lower than in controls. Cellularity was higher in ALL samples due to leukemic infiltration while the percentage of normal elements such as megakaryocytes, adipocytes, osteoblasts and osteoclasts were all significantly lower. During the course of Induction therapy, there was a decrease in the cellularity of ALL samples at day 15 of therapy with a further decrease at the end of Induction and an increase in the area occupied by adipocytes and the width of sinusoids. Reticulin fibrosis decreased throughout Induction. Megakaryocytes increased, osteoblasts and osteoclasts remained unchanged. No correlation was found between clinical presentation, early response to treatment and morphological changes. Our results provide a morphological background to further studies of bone marrow stroma in ALL.
Keywords: Bone Marrow; Humans; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Immunohistochemistry; Case-Control Studies; Adolescent; Child; Child, Preschool; Infant; Female; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Induction Chemotherapy
Rights: © 2015 Nguyen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
RMID: 0030031746
DOI: 10.1371/journal.pone.0126233
Appears in Collections:Medicine publications

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