Gelatinous transformation of marrow in a case of acute myelogenous leukemia post‐chemotherapy

Feng, Chi-Shun

doi:10.1002/ajh.2830380312

Cited by 17 publications

(13 citation statements)

References 7 publications

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“…A variant of GMT without fat cell atrophy has also been described in acute myeloblastic leukemia after chemotherapy [9]. This pattern was also seen in a case of CML described by Hong et al [7] and possibly our patient too has this variant.…”

supporting

confidence: 50%

Gelatinous Marrow Transformation in an Imatinib-Treated CML Patient with Pancytopenia Following Severe Sepsis

Agrawal

Sharma

Narang

et al. 2012

Indian J Hematol Blood Transfus

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Dear Sir, We read with interest the article by Srinivas et al. [1] describing morphological changes in bone marrows of chronic myeloid leukemia (CML) patients treated with imatinib mesylate (IM). We would like to share our experience with one such case with an unusual marrow finding.A 60-year-old male, a chronic smoker, was first diagnosed with low-grade transitional cell carcinoma (TCC), urinary bladder in 2003 after he underwent endoscopic transurethral resection of a bladder tumor (TURBT). He suffered local recurrences in 2004 and 2005, and repeat TURBTs were done followed by administration of intravesical BCG, and subsequently gemcitabine and mitomycin. The third TURBT in 2005 was complicated by bladder perforation requiring lapartomic repair.He remained well till 2008 when routine follow-up hemograms revealed persistent leukocytosis. The spleen, impalpable clinically, was mildly enlarged on ultrasound. Investigations revealed hemoglobin 8.8 gm %, platelets 868 9 10 9 /l and TLC 68.3 9 10 9 /l with 56 % neutrophils, 2 % lymphocytes, 5 % eosinophils, 10 % basophils, 1 % promyelocytes, 13 % myelocytes and 13 % metamyelocytes. Leukocyte alkaline phosphatase score was five (reference range 40-100) and reverse transcriptase PCR for the p210 bcr-abl fusion transcript was positive.

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supporting

confidence: 50%

Gelatinous Marrow Transformation in an Imatinib-Treated CML Patient with Pancytopenia Following Severe Sepsis

Agrawal

Sharma

Narang

et al. 2012

Indian J Hematol Blood Transfus

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“…In addition to the classical syndrome, a variant of GMT characterized by adipocyte hyperplasia has been described in postchemotherapy leukemia and myeloma patients and in patients with myelofibrosis treated with cytoreductive drugs [9,10,11,12]. Clinically, unlike the classical form, chemotherapy-associated GMT was acute in onset, transient and not associated with cachexia [9].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that in leukemic patients the malignant cells may produce hyaluronic acid as a transient event, culminating by filling up of marrow space by either hematopoietic precursors or the leukemic cells themselves [9, 10]. In these cases GMT might not have any prognostic significance and survival of the patients is dependent solely on the nature of the malignant process [10]. The direct relationship between cancer and GMT may involve catabolic processes that have been shown to stimulate the biosynthesis of mucopolysaccharides and are reversible when catabolism is eliminated [1].…”

Section: Discussionmentioning

confidence: 99%

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Gelatinous Transformation of Bone Marrow in Chronic Myeloid Leukemia during Treatment with Imatinib Mesylate: A Disease or a Drug Effect?

Ram¹,

Gafter‐Gvili²,

Okon

et al. 2008

Acta Haematol

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Gelatinous marrow transformation (GMT) is an unusual pathological manifestation of progressive malignant diseases and severe malnutrition states. GMT has been associated with various accelerated hematological malignancies, but has never been described in patients with chronic myelogenous leukemia (CML) treated with imatinib mesylate (IM), a novel tyrosine kinase inhibitor. Herein we report 2 patients with stable chronic phase CML who developed GMT during the course of treatment with IM. A comprehensive review of the relevant published data, several possible mechanisms and therapeutic alternatives are suggested.

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“…GMT is not a specific disease of the bone marrow, but it is instead associated with generalized severe illnesses (3). There are several reports of the associations between GMT and anorexia nervosa (4)(5)(6), malignancy (7,8) and infectious diseases such as tuberculosis (9), human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) (10,11). However, there have so far been few reports describing the associations between GMT and metabolic abnormalities.We herein present the first reported case of an association between GMT and a primary insufficiency of the adrenal and thyroid glands.…”

Section: Introductionmentioning

confidence: 99%

Resolution of Gelatinous Bone Marrow Transformation Following Hormone Replacement Therapy in a Patient with Primary Insufficiency of the Adrenal and Thyroid Glands

et al. 2013

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A 59-year-old man with recurrent oral cancer presented with severe pancytopenia, hyponatremia and hypoglycemia. Endocrine testing showed a partial primary adrenal insufficiency and primary hypothyroidism. The bone marrow biopsy showed a gelatinous transformation with hypocellularity and fat atrophy. His pancytopenia, hyponatremia and hypoglycemia resolved following treatment with corticosteroids and thyroid hormone replacement therapy. The follow-up bone marrow biopsy demonstrated a resolution of the gelatinous transformation. This case is a rare example of a patient with a primary insufficiency of the adrenal and thyroid glands that is associated with gelatinous bone marrow transformation (GMT). The GMT was resolved through the admimistration of corticosteroids and thyroid hormone replacement therapy.

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Gelatinous transformation of marrow in a case of acute myelogenous leukemia post‐chemotherapy

Cited by 17 publications

References 7 publications

Gelatinous Marrow Transformation in an Imatinib-Treated CML Patient with Pancytopenia Following Severe Sepsis

Gelatinous Marrow Transformation in an Imatinib-Treated CML Patient with Pancytopenia Following Severe Sepsis

Gelatinous Transformation of Bone Marrow in Chronic Myeloid Leukemia during Treatment with Imatinib Mesylate: A Disease or a Drug Effect?

Resolution of Gelatinous Bone Marrow Transformation Following Hormone Replacement Therapy in a Patient with Primary Insufficiency of the Adrenal and Thyroid Glands

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