Evidence for clonal disease by magnetic resonance imaging in patients with
hypoplastic marrow disorders
W Negendank, D Weissman, TM Bey, MM de Planque, C Karanes, MR Smith, V Ratanatharathorn, CR Bishop, AM al-Katib and LL Sensenbrenner
Department of Medicine, Harper Hospital, Wayne State University, Detroit,
MI.
Some patients with hypoplastic marrow disorders, including aplastic anemia
(AA), are at risk for clonal evolution to myelodysplastic syndromes (MDS)
and leukemia. Magnetic resonance imaging (MRI) of marrow of the spine,
pelvis, and femurs was performed in 24 patients with hypoplastic marrow
disorders. In 12 patients (three AA, nine MDS) MRI was compatible with the
clinical and biopsy diagnoses and served to define the spectrum of marrow
patterns in these disorders. In eight patients with hypocellular marrow
biopsies and a clinical diagnosis of AA, MRI showed an unexpected
inhomogeneous or diffuse cellular pattern. Concurrent or subsequent marrow
or cytogenetic studies have led to diagnoses of hypoplastic MDS in seven of
these patients. In four patients with prolonged hypoplasia after bone
marrow transplantation for lymphoma, a speckled pattern superimposed on a
fatty background appeared in serial MRI studies. One case evolved to AML,
two developed megaloblastic foci, and one remains hypoplastic at 19 months.
This study suggests that MRI is able to detect early clonal disease in
patients with AA, and can distinguish AA from hypoplastic MDS.
Volume 78,
Issue 11,
pp. 2872-2879,
12/01/1991
Copyright © 1991 by The American Society of Hematology
