Bone Marrow Biopsies Updated

Bone Marrow Biopsies Updated

Bibliotheca Haematologica Haematologíca rτo. No. 50 Series Editor A. Hässig, Bern Haematologica S.Karger Basel München Paris London NewYork Tokyo Sydney

Satellite Symposium of the 7th Congress of the International Society of Haematology, European and African Division, Barcelona, September 4-9, 1983 Bone Marrow Biopsies Up dated New Prospects for Clinical Diagnostics Volume Editors B. Frisch, Tel Aviv; R. Barti, München 48 figures and 40 tables, 1984 Haematologica S. Karger Basel München Paris London NewΥοrk Tokyo Sydney

Bertha Frisch Prof. Dr. med., Institute of Hematology, Ichilov Hospital, Tel-Aviv Municipal- Governmental Centre; and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel Reiner Bart! Prof. Dr. med., Abteilung für Knochenmarksdiagnostik, Medizinische Klinik Innenstadt der Universität München; Abteilung fúr Hämatοmοrphοlogie, Institut für Hämatologie, Gesellschaft für Strahlen- und Umweltforschung mbh, München, FRG National Library of Medicine, Cataloging in Publication Bone marrow biopsies updated: new prospects for clinical diagnostics / Satellite Symposium of the 7th Congress of the International Society of Haematology, European and African Division, Barcelona, September 4-9, 1983 Volume Editors, B. Frisch, R. Bartl.- Basel; New York: Karger, 1984.- (Bibliotheca haematologica; no. 50) Includes Index 1. Biopsy - congresses 2. Bone Marrow Examination - congresses 3. Lymphoproliferative Disorders - pathology - congresses 4. Myeloproliferative Disorders - pathology - congresses I. Frisch, B. (Bertha) II. Bartl, R. (Reiner) III. International Society of Hematology. European and African Division. Congress (7th: 1983: Barcelona, Spain) IV. Series W 1 Β1412 no. 50 [WH 380 Β709 1983] ISBN 3-8055-3863-4 Drug Dosage The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 1984 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland) Printed in Switzerland by Thür AG Offsetdruck, Pratteln ISBN 3-8055-3863-4

Contents Preface VII I. Updated Methods and New Possibilities in Bone Marrow Biopsies Bart!, R.; Frisch, B.; Buchenríeder, B.; Sommerfeld, W.; Muthmann, H.; Jäger, K.; Hoffmann-Fezer, G.; Burkhardt, R. (Iünchen/Tel Aviv): Multiparameter Studies on 650 Bone Marrow Biopsy Cores. Diagnostic Value of Combined Utilisation of Imprints, Cryostat and Plastic Sections in Medical Practice 1 II. Bone Marrow Biopsies in Myeloproliferative Disorders (MPD) Islam, Α.; Catovsky, D.; Goldman, J.M.; Galton, D.A.G. (London): Studies on Cellular Interactions between Stromal and Haemopoietic Stem Cells in Normal and Leukaemic Bone Marrows 17 Tricot, G.; Wolf-Peeters, C. De; Vlietinck, R.; Verwilghen, R.L. (Leuven): The Importance of Bone Marrow Biopsy in Myelodysplastic Disorders 31 Georgii, Α.; Vykoupil, K.F.; Thiele, J. (Hannover): Classification of Chronic Myeloproliferative Diseases by Bone Marrow Biopsies. Hematological and Cytogenetic Findings and Clinical Course 41 Frisch, B.; Barti, R.; Burkhardt, R.; Jager, K.; Mahl, G.; Kettner, G. (Tel Aviv/München): Classification of Myeloproliferative Disorders by Bone Marrow Histology 57 III. Bone Marrow Biopsies in Lymphoproliferative Disorders (LPD) Rodriguez Fernández, J.M.; Montserrat, E.; Rozman, C.; Rios, Α.; Vallespi, M.T.; González Aza, C.; Alcalá, Α.; Gutiérrez, M.; Morey, M.; Brugués, R. (Barcelona): Sequential Bone Marrow Biopsy in Chronic Lymphocytic Leukaemia 81 Pangalis, G.A.; Roussou, P.A.; Kittas, C.; Fessas, P. (Athens): Clinical Significance of Patterns of Bone Marrow Involvement in Chronic Lymphocytic Leukemia and Small Lymphocytic (Well-Differentiated) Non-Hodgkin's Lymphoma 87 Bart!, R.; Frisch, B.; Kettner, G.; Hill, W.; Hofmann-Fezer, G.; Sund, M.; Burkhardt, R. (Miinchen/Tel Aviv): Histologic Classification of Lymphoproliferative Disorders in the Bone Marrow 98 Subject Index 128

Preface For most of this century, smears of aspirated sternal bone marrow served as the basis of morphologic investigation and diagnosis. Generally, emphasis had been placed on ín-depth understanding of cytochemistry and in some cases on electron microscopy of a cellular compartment suspected of being abnormal, i.e., those particular cells in lymphoid, myeloid or monocytoid malignancies. In recent years, bone marrow has come to be regarded as an organ with its own complex structure and thus, as a more integrated entity. Bone, stroma including fat and fixed cells and microcirculation each have their own functions and microtopography, interrelationships, and possible spheres of influence. They do not merely provide a static support for precursors of the formed elements of blood a concept exemplified by the hematopoietic inductive microenvironment required for establishing suitable niches where stem cells settle and develop into mature blood cells, before their release into the peripheral circulation. Consequently, the analysis of aspirates and sections of bone marrow are regarded as complementary procedures. Each contributes specific information that helps to clarify a disease process, thereby obtaining a more complete picture of many pathologic conditions affecting the bone marrow and bone. At the 7th Meeting of the International Society of Haematology and Blood Transfusion in Barcelona in September 1983, the President, Prof. C. Rozman, provided workers in the field with an opportunity to present their results at a satellite symposium devoted entirely to bone marrow biopsies. This volume, based on the reports presented at that symposium, illustrates some of the advances in hematologic oncology and provides new perspectives gleaned from bone biopsies in clinical medicine.