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    Bone Marrow Recovery by Morphometry during Induction Chemotherapy for Acute Lymphoblastic Leukemia in Children

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    11
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    Author
    Nguyen, T-V; Melville, A; Nath, S; Story, C; Howell, S; Sutton, R; Zannettino, A; Revesz, T
    Date
    2015-05-11
    Source Title
    PLoS One
    Publisher
    PUBLIC LIBRARY SCIENCE
    University of Melbourne Author/s
    Nguyen, Tuong-Vi
    Affiliation
    Obstetrics and Gynaecology
    Metadata
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    Document Type
    Journal Article
    Citations
    Nguyen, T. -V., Melville, A., Nath, S., Story, C., Howell, S., Sutton, R., Zannettino, A. & Revesz, T. (2015). Bone Marrow Recovery by Morphometry during Induction Chemotherapy for Acute Lymphoblastic Leukemia in Children. PLOS ONE, 10 (5), https://doi.org/10.1371/journal.pone.0126233.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/257362
    DOI
    10.1371/journal.pone.0126233
    Abstract
    Bone marrow architecture is grossly distorted at the diagnosis of ALL and details of the morphological changes that accompany response to Induction chemotherapy have not been reported before. While marrow aspirates are widely used to assess initial response to ALL therapy and provide some indications, we have enumerated marrow components using morphometric analysis of trephine samples with the aim of achieving a greater understanding of changes in bone marrow niches. Morphometric analyses were carried out in the bone marrow trephine samples of 44 children with ALL, using a NanoZoomer HT digital scanner. Diagnostic samples were compared to those of 32 control patients with solid tumors but without marrow involvement. Samples from patients with ALL had significantly increased fibrosis and the area occupied by bony trabeculae was lower than in controls. Cellularity was higher in ALL samples due to leukemic infiltration while the percentage of normal elements such as megakaryocytes, adipocytes, osteoblasts and osteoclasts were all significantly lower. During the course of Induction therapy, there was a decrease in the cellularity of ALL samples at day 15 of therapy with a further decrease at the end of Induction and an increase in the area occupied by adipocytes and the width of sinusoids. Reticulin fibrosis decreased throughout Induction. Megakaryocytes increased, osteoblasts and osteoclasts remained unchanged. No correlation was found between clinical presentation, early response to treatment and morphological changes. Our results provide a morphological background to further studies of bone marrow stroma in ALL.

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