Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1993 Oct;46(10):915–921. doi: 10.1136/jcp.46.10.915

Haemopoietic regrowth after chemotherapy for acute leukaemia: an immunohistochemical study of bone marrow trephine biopsy specimens.

B S Wilkins 1, A G Bostanci 1, M F Ryan 1, D B Jones 1
PMCID: PMC501618  PMID: 8227408

Abstract

AIM--To analyse haemopoietic regrowth and residual disease in bone marrow trephine biopsy specimens after treatment for acute leukaemia, using immunohistochemical staining. METHODS--Biopsy specimens before and after treatment were studied from patients diagnosed as having acute myeloid or lymphoblastic leukaemia. Specimens after treatment encompassed periods from two to 56 weeks from the start of treatment. Routine haematoxylin and eosin and Giemsa stained sections were evaluated in association with immunostained preparations. A panel of antibodies was used, which reacts with epitopes showing restricted expression dependent on the lineage or maturation stage of cells. Results were evaluated in the light of clinical, peripheral blood, and marrow aspirate findings. RESULTS--The speed and sequence of regrowth of haemopoietic cells were more variable than expected. Immunostaining highlighted features of dysplasia after treatment and in some cases assisted detection of residual or relapsed leukaemia. Peripheral blood and aspirate cell counts reflected accurately the amount of regrowth, but not the dysplasia, seen in biopsy samples. Delayed regrowth was associated with complex individual factors. CONCLUSIONS--Morphological and immunohistochemical study of trephine biopsy specimens from patients treated for acute leukaemia provides information complementary to that obtained from peripheral blood and aspirated marrow. Variation in the timing and sequence of regrowth is highlighted. Immunostaining can aid in the detection of relapse or minimal residual leukaemia. The clinical relevance of dysplastic changes in biopsy specimens after treatment is uncertain, but such changes may persist for long periods.

Full text

PDF
915

Images in this article

917Image
on p.917
918Image
on p.918
918Image
on p.918

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albrechtsen M., Kerr M. A. Characterization of human neutrophil glycoproteins expressing the CD15 differentiation antigen (3-fucosyl-N-acetyllactosamine). Br J Haematol. 1989 Jul;72(3):312–320. doi: 10.1111/j.1365-2141.1989.tb07710.x. [DOI] [PubMed] [Google Scholar]
  2. Brandtzaeg P., Jones D. B., Flavell D. J., Fagerhol M. K. Mac 387 antibody and detection of formalin resistant myelomonocytic L1 antigen. J Clin Pathol. 1988 Sep;41(9):963–970. doi: 10.1136/jcp.41.9.963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dexter T. M., Coutinho L. H., Spooncer E., Heyworth C. M., Daniel C. P., Schiro R., Chang J., Allen T. D. Stromal cells in haemopoiesis. Ciba Found Symp. 1990;148:76–95. doi: 10.1002/9780470513880.ch6. [DOI] [PubMed] [Google Scholar]
  4. Falini B., Flenghi L., Pileri S., Gambacorta M., Bigerna B., Durkop H., Eitelbach F., Thiele J., Pacini R., Cavaliere A. PG-M1: a new monoclonal antibody directed against a fixative-resistant epitope on the macrophage-restricted form of the CD68 molecule. Am J Pathol. 1993 May;142(5):1359–1372. [PMC free article] [PubMed] [Google Scholar]
  5. Gardner B., Parsons S. F., Merry A. H., Anstee D. J. Epitopes on sialoglycoprotein alpha: evidence for heterogeneity in the molecule. Immunology. 1989 Oct;68(2):283–289. [PMC free article] [PubMed] [Google Scholar]
  6. Gatter K. C., Cordell J. L., Turley H., Heryet A., Kieffer N., Anstee D. J., Mason D. Y. The immunohistological detection of platelets, megakaryocytes and thrombi in routinely processed specimens. Histopathology. 1988 Sep;13(3):257–267. doi: 10.1111/j.1365-2559.1988.tb02037.x. [DOI] [PubMed] [Google Scholar]
  7. Hsu S. M., Raine L., Fanger H. Use of avidin-biotin-peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures. J Histochem Cytochem. 1981 Apr;29(4):577–580. doi: 10.1177/29.4.6166661. [DOI] [PubMed] [Google Scholar]
  8. Islam A. Pattern of bone marrow regeneration following chemotherapy for acute myeloid leukemia. J Med. 1987;18(2):108–122. [PubMed] [Google Scholar]
  9. Naeim F., Smith G. S., Gale R. P. Morphologic aspects of bone marrow transplantation in patients with aplastic anemia. Hum Pathol. 1978 May;9(3):295–308. doi: 10.1016/s0046-8177(78)80087-2. [DOI] [PubMed] [Google Scholar]
  10. Pulford K. A., Erber W. N., Crick J. A., Olsson I., Micklem K. J., Gatter K. C., Mason D. Y. Use of monoclonal antibody against human neutrophil elastase in normal and leukaemic myeloid cells. J Clin Pathol. 1988 Aug;41(8):853–860. doi: 10.1136/jcp.41.8.853. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pulford K. A., Rigney E. M., Micklem K. J., Jones M., Stross W. P., Gatter K. C., Mason D. Y. KP1: a new monoclonal antibody that detects a monocyte/macrophage associated antigen in routinely processed tissue sections. J Clin Pathol. 1989 Apr;42(4):414–421. doi: 10.1136/jcp.42.4.414. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Quesenberry P. J., Mcniece I. K., McGrath H. E., Temeles D. S., Baber G. B., Deacon D. H. Stromal regulation of hematopoiesis. Ann N Y Acad Sci. 1989;554:116–124. doi: 10.1111/j.1749-6632.1989.tb22414.x. [DOI] [PubMed] [Google Scholar]
  13. Rajantie J., Sale G. E., Deeg H. J., Amos D., Appelbaum F., Storb R., Clift R. A., Buckner C. D. Adverse effect of severe marrow fibrosis on hematologic recovery after chemoradiotherapy and allogeneic bone marrow transplantation. Blood. 1986 Jun;67(6):1693–1697. [PubMed] [Google Scholar]
  14. Roberts M. M., Juttner C. A., To L. B., Kimber R. J. Bone marrow biopsy during induction chemotherapy for acute myeloid leukaemia identifies only 50% of patients with resistant disease. Leuk Res. 1988;12(10):817–821. doi: 10.1016/0145-2126(88)90035-5. [DOI] [PubMed] [Google Scholar]
  15. Sale G. E., Marmont P. Marrow mast cell counts do not predict bone marrow graft rejection. Hum Pathol. 1981 Jul;12(7):605–608. doi: 10.1016/s0046-8177(81)80043-3. [DOI] [PubMed] [Google Scholar]
  16. Tricot G., De Wolf-Peeters C., Hendrickx B., Verwilghen R. L. Bone marrow histology in myelodysplastic syndromes. I. Histological findings in myelodysplastic syndromes and comparison with bone marrow smears. Br J Haematol. 1984 Jul;57(3):423–430. doi: 10.1111/j.1365-2141.1984.tb02916.x. [DOI] [PubMed] [Google Scholar]
  17. Walls A. F., Jones D. B., Williams J. H., Church M. K., Holgate S. T. Immunohistochemical identification of mast cells in formaldehyde-fixed tissue using monoclonal antibodies specific for tryptase. J Pathol. 1990 Oct;162(2):119–126. doi: 10.1002/path.1711620204. [DOI] [PubMed] [Google Scholar]
  18. Wilkins B. S. Histology of normal haemopoiesis: bone marrow histology. I. J Clin Pathol. 1992 Aug;45(8):645–649. doi: 10.1136/jcp.45.8.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Wilkins B. S., Jones D. B. Cell-stroma interactions in monocytopoiesis. FEMS Microbiol Immunol. 1992 Dec;5(5-6):347–353. doi: 10.1111/j.1574-6968.1992.tb05920.x. [DOI] [PubMed] [Google Scholar]
  20. Wittels B. Bone marrow biopsy changes following chemotherapy for acute leukemia. Am J Surg Pathol. 1980 Apr;4(2):135–142. doi: 10.1097/00000478-198004000-00005. [DOI] [PubMed] [Google Scholar]
  21. van den Berg H., Kluin P. M., Vossen J. M. Early reconstitution of haematopoiesis after allogeneic bone marrow transplantation: a prospective histopathological study of bone marrow biopsy specimens. J Clin Pathol. 1990 May;43(5):365–369. doi: 10.1136/jcp.43.5.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. van den berg H., Kluin P. M., Zwaan F. E., Vossen J. M. Histopathology of bone marrow reconstitution after allogeneic bone marrow transplantation. Histopathology. 1989 Oct;15(4):363–373. doi: 10.1111/j.1365-2559.1989.tb01588.x. [DOI] [PubMed] [Google Scholar]
  23. van der Valk P., Mullink H., Huijgens P. C., Tadema T. M., Vos W., Meijer C. J. Immunohistochemistry in bone marrow diagnosis. Value of a panel of monoclonal antibodies on routinely processed bone marrow biopsies. Am J Surg Pathol. 1989 Feb;13(2):97–106. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES