Literature DB >> 16731597

Clinical significance of plasmacytosis in the day+14 bone marrow of patients with acute myeloid leukaemia undergoing induction chemotherapy.

Nada Al-Shughair1, Ghuzayel Al-Dawsari, Martin Gyger, Gamal Mohamed, George Roberts.   

Abstract

BACKGROUND: The design of chemotherapy-induction regimens for acute myeloid leukaemia (AML) is directed towards the early elimination of bone marrow (BM) leukaemic blast cells (LBCs). Patients with AML after induction show LBC reduction in a hypoplastic BM and also demonstrate a varying number of residual BM plasma cells (PCs). AIM: To relate PC number to several blood and BM parameters as well as clinical features such as infection and survival.
METHODS: On the 14th day after the start of chemotherapy (D+14) BM samples were examined for residual PCs in 60 adult (>or=15 years) patients undergoing AML-induction chemotherapy, and the proportion of PCs was related to blood and BM parameters including French-American-British (FAB) subtype, other inflammatory cells, antecedent infection, attainment of complete remission and 36-month survival.
RESULTS: Median PC proportion of 11.3% (range 0.1-48.7%) in D+14 BM aspirates and 10.7% (0.6-41%) in trephine biopsies was observed. Their number showed a direct relationship with residual BM lymphocytes (r=0.368; p=0.025). Higher numbers of residual PCs also reflected the presence of infection before diagnosis and coincident with treatment (p=0.039). Although we could not demonstrate an association between PC numbers and 36-month survival, PC numbers were significantly higher in patients with residual leukaemia at D>14 (p=0.007).
CONCLUSION: D+14 BM PC number reflects the effectiveness of induction chemotherapy and the presence of antecedent inflammation or infection.

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Year:  2006        PMID: 16731597      PMCID: PMC1994521          DOI: 10.1136/jcp.2005.032870

Source DB:  PubMed          Journal:  J Clin Pathol        ISSN: 0021-9746            Impact factor:   3.411


  10 in total

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