Michelson J D, Gornet M, Codd T, Torres J, Lanighan K, Jones R
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Exp Hematol. 1993 Mar;21(3):475-82.
The osteogenic consequences of bone marrow ablation followed by bone marrow transplantation for Hodgkin's and non-Hodgkin's lymphoma were examined. Pre- and post-transplantation iliac crest bone biopsies were reviewed for all patients undergoing transplantation at the Johns Hopkins Oncology Center between January 1981 and December 1989. Histomorphometric measurements included percentage of filled trabecular lacunae to estimate osteocyte viability, marrow cellularity and marrow fibrosis. A total of 37 non-Hodgkin's and 32 Hodgkin's patients had adequate biopsies for study inclusion. Twenty-seven received chemotherapy alone, while the remaining 42 had lethal total body irradiation plus chemotherapy. Twelve transplants were allogeneic. Estimated osteocyte viability was decreased for over 4 weeks after bone marrow transplantation. Continuing osteocyte dropout in the central regions of trabeculae was seen in conjunction with active new osteocyte formation along the periphery. Marrow fibrosis was significantly increased and marrow cellularity decreased. There were no major distinctions based on lymphoma type, pretransplant treatment regimen or type of bone marrow transplant. The results indicate that disruption of marrow hematopoiesis causes a diminution in osteocyte viability. Although there is an early appearance of new osteogenesis, the source of progenitor cells cannot be determined from this study.
我们研究了霍奇金淋巴瘤和非霍奇金淋巴瘤患者在接受骨髓消融后进行骨髓移植的成骨后果。对1981年1月至1989年12月期间在约翰霍普金斯肿瘤中心接受移植的所有患者，回顾其移植前后的髂嵴骨活检情况。组织形态计量学测量包括填充小梁腔隙的百分比，以评估骨细胞活力、骨髓细胞密度和骨髓纤维化程度。共有37例非霍奇金淋巴瘤患者和32例霍奇金淋巴瘤患者的活检标本符合研究纳入标准。27例患者仅接受化疗，其余42例接受致死性全身照射加化疗。12例移植为同种异体移植。骨髓移植后4周以上，骨细胞活力估计值下降。在小梁中央区域持续可见骨细胞缺失，同时在周边可见活跃的新骨细胞形成。骨髓纤维化显著增加，骨髓细胞密度降低。基于淋巴瘤类型、移植前治疗方案或骨髓移植类型，未发现明显差异。结果表明，骨髓造血功能的破坏导致骨细胞活力降低。虽然早期出现了新骨形成，但本研究无法确定祖细胞的来源。
