The Experts below are selected from a list of 225 Experts worldwide ranked by ideXlab platform
Geoffrey D Wool - One of the best experts on this subject based on the ideXlab platform.
-
how i investigate Bone Marrow Necrosis
International Journal of Laboratory Hematology, 2019Co-Authors: Anne Deucher, Geoffrey D WoolAbstract:Hematopathologists encounter Bone Marrow biopsy specimens with Marrow Necrosis relatively infrequently; when Necrosis is seen, determining the clinical significance can be challenging. While Bone Marrow Necrosis is not uncommon in site-directed biopsy specimens or autopsy material, substantial Necrosis is much less common in nondirected Bone Marrow biopsy specimens. Retrospective review showed the prevalence of Bone Marrow Necrosis to vary between 0.3% and 2% antemortem, depending on the patient population. Numerous causes of Bone Marrow Necrosis have been identified, including malignancy, radiation/chemotherapy, medication, infection, autoimmune disease, disseminated intravascular coagulation, antiphospholipid syndrome and other thrombotic disorders, granulocyte-colony stimulating factor (G-CSF) exposure, and hemoglobinopathies. Clinical findings associated with Bone Marrow Necrosis include Bone pain and fever, cytopenias, elevated LDH and ferritin, and leukoerythroblastosis. Rarely, such as in fat embolization syndrome (FES), Bone Marrow Necrosis can be associated with thrombotic microangiopathy, neurologic dysfunction, and multiorgan failure. A thorough review of the patient's clinical record (including medical history, clinical presentation, and other laboratory findings), a thorough morphologic review of the Bone Marrow with appropriate ancillary stains, and an appreciation of the causes of Bone Marrow Necrosis in different patient populations are required to determine the underlying cause of Bone Marrow Necrosis. The purpose of this review is to present a strategy for evaluation of Bone Marrow Necrosis found in an antemortem biopsy specimen.
-
Bone Marrow Necrosis ten year retrospective review of Bone Marrow biopsy specimens
American Journal of Clinical Pathology, 2015Co-Authors: Geoffrey D Wool, Anne DeucherAbstract:Objectives: Bone Marrow can undergo Necrosis for many different causes; malignant causes are reported to be more frequent. Methods: We undertook a 10-year retrospective review of all Bone Marrow biopsy specimens with Bone Marrow Necrosis at our institution. Results: Identified cases represented approximately 0.3% of our Bone Marrow cases. Most identified Bone Marrow cases with Necrosis were involved by metastatic tumor or hematolymphoid malignancy (90% of total) in relatively equal proportions. In those cases of Bone Marrow Necrosis with hematolymphoid malignancy, lymphoid disease predominated and the Necrosis was often seen in the setting of chemotherapy. In metastatic tumor cases, Necrosis seemed to enrich in prostate adenocarcinoma and Ewing sarcoma/primitive neuroectodermal tumor; neuroblastoma showed much less Necrosis. Ten percent of patients with Bone Marrow Necrosis had no underlying malignancy, and the associated causes varied. Conclusions: The causes of Bone Marrow Necrosis are diverse but should always prompt careful assessment for malignancy and infectious etiology.
-
Bone Marrow Necrosis ten year retrospective review of Bone Marrow biopsy specimens
American Journal of Clinical Pathology, 2015Co-Authors: Geoffrey D Wool, Anne DeucherAbstract:Objectives: Bone Marrow can undergo Necrosis for many different causes; malignant causes are reported to be more frequent. Methods: We undertook a 10-year retrospective review of all Bone Marrow biopsy specimens with Bone Marrow Necrosis at our institution. Results: Identified cases represented approximately 0.3% of our Bone Marrow cases. Most identified Bone Marrow cases with Necrosis were involved by metastatic tumor or hematolymphoid malignancy (90% of total) in relatively equal proportions. In those cases of Bone Marrow Necrosis with hematolymphoid malignancy, lymphoid disease predominated and the Necrosis was often seen in the setting of chemotherapy. In metastatic tumor cases, Necrosis seemed to enrich in prostate adenocarcinoma and Ewing sarcoma/primitive neuroectodermal tumor; neuroblastoma showed much less Necrosis. Ten percent of patients with Bone Marrow Necrosis had no underlying malignancy, and the associated causes varied. Conclusions: The causes of Bone Marrow Necrosis are diverse but should always prompt careful assessment for malignancy and infectious etiology.
Anne Deucher - One of the best experts on this subject based on the ideXlab platform.
-
how i investigate Bone Marrow Necrosis
International Journal of Laboratory Hematology, 2019Co-Authors: Anne Deucher, Geoffrey D WoolAbstract:Hematopathologists encounter Bone Marrow biopsy specimens with Marrow Necrosis relatively infrequently; when Necrosis is seen, determining the clinical significance can be challenging. While Bone Marrow Necrosis is not uncommon in site-directed biopsy specimens or autopsy material, substantial Necrosis is much less common in nondirected Bone Marrow biopsy specimens. Retrospective review showed the prevalence of Bone Marrow Necrosis to vary between 0.3% and 2% antemortem, depending on the patient population. Numerous causes of Bone Marrow Necrosis have been identified, including malignancy, radiation/chemotherapy, medication, infection, autoimmune disease, disseminated intravascular coagulation, antiphospholipid syndrome and other thrombotic disorders, granulocyte-colony stimulating factor (G-CSF) exposure, and hemoglobinopathies. Clinical findings associated with Bone Marrow Necrosis include Bone pain and fever, cytopenias, elevated LDH and ferritin, and leukoerythroblastosis. Rarely, such as in fat embolization syndrome (FES), Bone Marrow Necrosis can be associated with thrombotic microangiopathy, neurologic dysfunction, and multiorgan failure. A thorough review of the patient's clinical record (including medical history, clinical presentation, and other laboratory findings), a thorough morphologic review of the Bone Marrow with appropriate ancillary stains, and an appreciation of the causes of Bone Marrow Necrosis in different patient populations are required to determine the underlying cause of Bone Marrow Necrosis. The purpose of this review is to present a strategy for evaluation of Bone Marrow Necrosis found in an antemortem biopsy specimen.
-
Bone Marrow Necrosis ten year retrospective review of Bone Marrow biopsy specimens
American Journal of Clinical Pathology, 2015Co-Authors: Geoffrey D Wool, Anne DeucherAbstract:Objectives: Bone Marrow can undergo Necrosis for many different causes; malignant causes are reported to be more frequent. Methods: We undertook a 10-year retrospective review of all Bone Marrow biopsy specimens with Bone Marrow Necrosis at our institution. Results: Identified cases represented approximately 0.3% of our Bone Marrow cases. Most identified Bone Marrow cases with Necrosis were involved by metastatic tumor or hematolymphoid malignancy (90% of total) in relatively equal proportions. In those cases of Bone Marrow Necrosis with hematolymphoid malignancy, lymphoid disease predominated and the Necrosis was often seen in the setting of chemotherapy. In metastatic tumor cases, Necrosis seemed to enrich in prostate adenocarcinoma and Ewing sarcoma/primitive neuroectodermal tumor; neuroblastoma showed much less Necrosis. Ten percent of patients with Bone Marrow Necrosis had no underlying malignancy, and the associated causes varied. Conclusions: The causes of Bone Marrow Necrosis are diverse but should always prompt careful assessment for malignancy and infectious etiology.
-
Bone Marrow Necrosis ten year retrospective review of Bone Marrow biopsy specimens
American Journal of Clinical Pathology, 2015Co-Authors: Geoffrey D Wool, Anne DeucherAbstract:Objectives: Bone Marrow can undergo Necrosis for many different causes; malignant causes are reported to be more frequent. Methods: We undertook a 10-year retrospective review of all Bone Marrow biopsy specimens with Bone Marrow Necrosis at our institution. Results: Identified cases represented approximately 0.3% of our Bone Marrow cases. Most identified Bone Marrow cases with Necrosis were involved by metastatic tumor or hematolymphoid malignancy (90% of total) in relatively equal proportions. In those cases of Bone Marrow Necrosis with hematolymphoid malignancy, lymphoid disease predominated and the Necrosis was often seen in the setting of chemotherapy. In metastatic tumor cases, Necrosis seemed to enrich in prostate adenocarcinoma and Ewing sarcoma/primitive neuroectodermal tumor; neuroblastoma showed much less Necrosis. Ten percent of patients with Bone Marrow Necrosis had no underlying malignancy, and the associated causes varied. Conclusions: The causes of Bone Marrow Necrosis are diverse but should always prompt careful assessment for malignancy and infectious etiology.
Farhad Ravandi - One of the best experts on this subject based on the ideXlab platform.
-
outcomes of patients pts with acute lymphoblastic leukemia all and acute myeloid leukemia aml with Bone Marrow Necrosis bmn at initial diagnosis
Journal of Clinical Oncology, 2014Co-Authors: Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Tapan M Kadia, Naval Daver, Deborah A Thomas, Hagop M Kantarjian, Farhad RavandiAbstract:e18017 Background: Bone Marrow Necrosis (BMN) at initial diagnosis in acute leukemias is a rare pathological finding with only few cases reported in the literature. The purpose of this study was to...
-
outcomes of patients pts with acute lymphoblastic leukemia all and acute myeloid leukemia aml with Bone Marrow Necrosis bmn at initial diagnosis
Journal of Clinical Oncology, 2014Co-Authors: Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Tapan M Kadia, Naval Daver, Deborah A Thomas, Hagop M Kantarjian, Farhad RavandiAbstract:e18017 Background: Bone Marrow Necrosis (BMN) at initial diagnosis in acute leukemias is a rare pathological finding with only few cases reported in the literature. The purpose of this study was to determine the clinical impact of BMN at initial diagnosis in pts with ALL and AML. Methods: We performed a chart review of pts with ALL and AML with BMN at initial diagnosis, treated at our institution. Results: 640 ALL pts and 1051 AML pts were treated at our institution between 2000 and 2013. BMN was identified in 20 (3.1%) and 25 (2.4%) pts with ALL and AML at initial diagnosis. The most common cytogenetic findings in pts with ALL included t(9;22)(q34;q11) in 3 pts (15%) and t(8;14)(q24;q32) in 5 pts (25%). 16 pts (80%) were treated with a hyper-CVAD based induction regimen. 17 pts (85%) achieved complete remission (CR). The median CR duration was 48.7 months (range, 1.7-137.1 months). 11 pts (55%) have died at the time of this analysis with a median overall survival of 61.5 months (range, 0-120 months) comp...
Aditya Shetty - One of the best experts on this subject based on the ideXlab platform.
-
Bone Marrow Necrosis in acute leukemia clinical characteristic and outcome
American Journal of Hematology, 2015Co-Authors: Talha Badar, Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Marina Konopleva, Xuelin Huang, Hsiang Chun Chen, Tapan M KadiaAbstract:Bone Marrow Necrosis (BMN) is characterized by infarction of the medullary stroma, leading to Marrow Necrosis with preserved cortical Bone. In reported small series, BMN in hematological malignancies is associated with poor prognosis. We sought to find the impact of BMN on clinical outcome in a relatively larger cohort of patients with acute leukemias. Overall we evaluated 1,691 patients; 1,051 with acute myeloid leukemia (AML) and 640 with acute lymphocytic leukemia referred to our institution between 2002 and 2013. Patients with AML and acute lymphoblastic leukemia (ALL) were evaluated separately to determine the incidence of BMN, associated clinical features and its prognostic significance. At initial diagnosis, BMN was observed in 25 (2.4%) patients with AML and 20 (3.2%) patients with ALL. In AML, BMN was significantly associated with French–American–British AML M5 morphology (32% vs. 10%, P = 0.002). The complete remission (CR) rate in AML with and without BMN was 32% and 59% respectively (P = 0.008). Likewise, CR rate in ALL with BMN was also inferior, 70% vs. 92% (P = 0.005). The median overall survival (OS) in AML with BMN was significantly poorer, 3.7 months compared to 14 months without BMN (P = 0.003). Similarly, the median OS in ALL with and without BMN was 61.7 and 72 months respectively (P = 0.33). BMN is not a rare entity in AML and ALL, but is infrequent. BMN in AML and in ALL is suggestive of inferior response and poor prognosis. Am. J. Hematol. 90:769–773, 2015. © 2015 Wiley Periodicals, Inc.
-
outcomes of patients pts with acute lymphoblastic leukemia all and acute myeloid leukemia aml with Bone Marrow Necrosis bmn at initial diagnosis
Journal of Clinical Oncology, 2014Co-Authors: Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Tapan M Kadia, Naval Daver, Deborah A Thomas, Hagop M Kantarjian, Farhad RavandiAbstract:e18017 Background: Bone Marrow Necrosis (BMN) at initial diagnosis in acute leukemias is a rare pathological finding with only few cases reported in the literature. The purpose of this study was to...
-
outcomes of patients pts with acute lymphoblastic leukemia all and acute myeloid leukemia aml with Bone Marrow Necrosis bmn at initial diagnosis
Journal of Clinical Oncology, 2014Co-Authors: Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Tapan M Kadia, Naval Daver, Deborah A Thomas, Hagop M Kantarjian, Farhad RavandiAbstract:e18017 Background: Bone Marrow Necrosis (BMN) at initial diagnosis in acute leukemias is a rare pathological finding with only few cases reported in the literature. The purpose of this study was to determine the clinical impact of BMN at initial diagnosis in pts with ALL and AML. Methods: We performed a chart review of pts with ALL and AML with BMN at initial diagnosis, treated at our institution. Results: 640 ALL pts and 1051 AML pts were treated at our institution between 2000 and 2013. BMN was identified in 20 (3.1%) and 25 (2.4%) pts with ALL and AML at initial diagnosis. The most common cytogenetic findings in pts with ALL included t(9;22)(q34;q11) in 3 pts (15%) and t(8;14)(q24;q32) in 5 pts (25%). 16 pts (80%) were treated with a hyper-CVAD based induction regimen. 17 pts (85%) achieved complete remission (CR). The median CR duration was 48.7 months (range, 1.7-137.1 months). 11 pts (55%) have died at the time of this analysis with a median overall survival of 61.5 months (range, 0-120 months) comp...
Tapan M Kadia - One of the best experts on this subject based on the ideXlab platform.
-
Bone Marrow Necrosis in acute leukemia clinical characteristic and outcome
American Journal of Hematology, 2015Co-Authors: Talha Badar, Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Marina Konopleva, Xuelin Huang, Hsiang Chun Chen, Tapan M KadiaAbstract:Bone Marrow Necrosis (BMN) is characterized by infarction of the medullary stroma, leading to Marrow Necrosis with preserved cortical Bone. In reported small series, BMN in hematological malignancies is associated with poor prognosis. We sought to find the impact of BMN on clinical outcome in a relatively larger cohort of patients with acute leukemias. Overall we evaluated 1,691 patients; 1,051 with acute myeloid leukemia (AML) and 640 with acute lymphocytic leukemia referred to our institution between 2002 and 2013. Patients with AML and acute lymphoblastic leukemia (ALL) were evaluated separately to determine the incidence of BMN, associated clinical features and its prognostic significance. At initial diagnosis, BMN was observed in 25 (2.4%) patients with AML and 20 (3.2%) patients with ALL. In AML, BMN was significantly associated with French–American–British AML M5 morphology (32% vs. 10%, P = 0.002). The complete remission (CR) rate in AML with and without BMN was 32% and 59% respectively (P = 0.008). Likewise, CR rate in ALL with BMN was also inferior, 70% vs. 92% (P = 0.005). The median overall survival (OS) in AML with BMN was significantly poorer, 3.7 months compared to 14 months without BMN (P = 0.003). Similarly, the median OS in ALL with and without BMN was 61.7 and 72 months respectively (P = 0.33). BMN is not a rare entity in AML and ALL, but is infrequent. BMN in AML and in ALL is suggestive of inferior response and poor prognosis. Am. J. Hematol. 90:769–773, 2015. © 2015 Wiley Periodicals, Inc.
-
outcomes of patients pts with acute lymphoblastic leukemia all and acute myeloid leukemia aml with Bone Marrow Necrosis bmn at initial diagnosis
Journal of Clinical Oncology, 2014Co-Authors: Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Tapan M Kadia, Naval Daver, Deborah A Thomas, Hagop M Kantarjian, Farhad RavandiAbstract:e18017 Background: Bone Marrow Necrosis (BMN) at initial diagnosis in acute leukemias is a rare pathological finding with only few cases reported in the literature. The purpose of this study was to...
-
outcomes of patients pts with acute lymphoblastic leukemia all and acute myeloid leukemia aml with Bone Marrow Necrosis bmn at initial diagnosis
Journal of Clinical Oncology, 2014Co-Authors: Aditya Shetty, Carlos E Buesoramos, Jorge E Cortes, Gautam Borthakur, Sherry Pierce, Tapan M Kadia, Naval Daver, Deborah A Thomas, Hagop M Kantarjian, Farhad RavandiAbstract:e18017 Background: Bone Marrow Necrosis (BMN) at initial diagnosis in acute leukemias is a rare pathological finding with only few cases reported in the literature. The purpose of this study was to determine the clinical impact of BMN at initial diagnosis in pts with ALL and AML. Methods: We performed a chart review of pts with ALL and AML with BMN at initial diagnosis, treated at our institution. Results: 640 ALL pts and 1051 AML pts were treated at our institution between 2000 and 2013. BMN was identified in 20 (3.1%) and 25 (2.4%) pts with ALL and AML at initial diagnosis. The most common cytogenetic findings in pts with ALL included t(9;22)(q34;q11) in 3 pts (15%) and t(8;14)(q24;q32) in 5 pts (25%). 16 pts (80%) were treated with a hyper-CVAD based induction regimen. 17 pts (85%) achieved complete remission (CR). The median CR duration was 48.7 months (range, 1.7-137.1 months). 11 pts (55%) have died at the time of this analysis with a median overall survival of 61.5 months (range, 0-120 months) comp...