Bone morphology after bone marrow transplantation for Hodgkin's and non-Hodgkin's lymphoma.

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.