Abstract
Bone marrow biopsy evaluation after therapy for hematolymphoid disorders is complex. The difficulties encountered by the pathologist are due to the fact that a variety of heterogenous diseases for which different treatments can be applied have to be considered. Moreover, usually different clinical questions have to be addressed for which different analyses are performed, typically in different laboratories by different investigators. In the present paper, we suggest a systematic, integrative and interdisciplinary approach that includes knowledge of the original diagnosis and of the type of prior therapy, considers treatment effects and a use of standardized response criteria for AML and MDS. Finally, we discuss how to deal with discrepancies between morphological findings in a bone marrow biopsy and the corresponding aspirate.
MeSH terms
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Acute Disease
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Antineoplastic Agents / pharmacology
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Antineoplastic Agents / therapeutic use
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Biopsy
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Bone Marrow / drug effects
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Bone Marrow / pathology*
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Bone Marrow Transplantation
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Chronic Disease
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Humans
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis*
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
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Leukemia, Myeloid / diagnosis*
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Leukemia, Myeloid / pathology
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Leukemia, Myeloid / therapy
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Myelodysplastic Syndromes / diagnosis*
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Myelodysplastic Syndromes / pathology
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Myelodysplastic Syndromes / therapy
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Myeloproliferative Disorders / diagnosis*
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Myeloproliferative Disorders / pathology
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Myeloproliferative Disorders / therapy
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
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Treatment Outcome