RESUMO
The specific features of interactions between megakaryocytic and granulocytic hematopoiesis lineages and myelofibrosis were studied in patients with active phase (before treatment) of chronic myeloid leukemia, chronic lymphocytic leukemia, and multiple myeloma. In patients with chronic myeloid leukemia, a direct correlation was found between the severity of both early and advanced myelofibrosis and the number of megakaryocytes in the bone marrow irrespectively of the type of the bone marrow tumor. The parameters of granulocytic hematopoiesis lineage were higher in myelofibrosis. In patients with chronic lymphocytic leukemia and multiple myeloma, negative correlations between the severity of early and advanced myelofibrosis and the number of megakaryocytes in the bone marrow and platelets in the peripheral blood were found. In chronic lymphocytic leukemia, negative correlations between the severity of early and advanced myelofibrosis and the number of neutrophils in the bone marrow and peripheral blood were detected. In patients with multiple myeloma, negative correlations between the severity of advanced myelofibrosis and number of neutrophils in the bone marrow and peripheral blood were detected.
Assuntos
Granulócitos/patologia , Hematopoese , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Megacariócitos/patologia , Mieloma Múltiplo/diagnóstico , Mielofibrose Primária/diagnóstico , Adulto , Autopsia , Medula Óssea/metabolismo , Medula Óssea/patologia , Estudos de Casos e Controles , Comunicação Celular , Contagem de Células , Progressão da Doença , Feminino , Granulócitos/classificação , Granulócitos/metabolismo , Humanos , Leucemia Linfocítica Crônica de Células B/metabolismo , Leucemia Linfocítica Crônica de Células B/patologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/metabolismo , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Masculino , Megacariócitos/classificação , Megacariócitos/metabolismo , Pessoa de Meia-Idade , Mieloma Múltiplo/metabolismo , Mieloma Múltiplo/patologia , Mielofibrose Primária/metabolismo , Mielofibrose Primária/patologia , Índice de Gravidade de DoençaRESUMO
We performed comparative analysis of quantitative changes in the populations of bone marrow microenvironment cells in patients with chronic myeloid leukemia, multiple myeloma, and chronic lymphocytic leukemia in the debut, during response to chemotherapy, and during relapse/progression/loss of response. It was shown that in the active phase of hemoblastoses, the number of reticular cells and fibroblasts in trephine biopsy specimens was higher than in the phase of response to chemotherapy and than in the control group. In patients with relapse of multiple myeloma and loss of response in chronic myeloid leukemia, the percentage ratio of adipocytes in the bone marrow significantly (by 9-13-fold) increased. In addition, endotheliocytes appear in the active phase of all hemoblastoses in trephine biopsy specimens, while in the phase of response to chemotherapy and in the control group, these cells were absent. The revealed quantitative changes in bone marrow stromal cells can be taken into account during assessing the phase of hemoblastosis and effectiveness of chemotherapy.
Assuntos
Antineoplásicos/farmacologia , Medula Óssea/patologia , Leucemia Linfocítica Crônica de Células B/metabolismo , Leucemia Mielogênica Crônica BCR-ABL Positiva/metabolismo , Mieloma Múltiplo/metabolismo , Microambiente Tumoral , Biópsia , Medula Óssea/fisiologia , Proliferação de Células , Citocinas/metabolismo , Feminino , Fibroblastos/citologia , Humanos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/tratamento farmacológico , Recidiva Local de NeoplasiaRESUMO
Pathomorphological study of trephinobiopsy specimens from 129 patients with lymphoproliferative and myeloproliferative diseases was carried out over the course of chemotherapy. Combinations of initial and manifest myelofibrosis (loose network of reticulin fibers and extensive network of reticulin and collagen fibers, respectively) predominated at the debut of chronic myeloid leukemia, chronic lymphoid leukemia, and multiple myeloma. Manifest myelofibrosis was detected in patients with chronic myeloid leukemia without hematological response (failure of normalization of hematological values) and in patients with progressing and relapsing multiple myeloma. Combinations of foci of initial and manifest myelofibrosis were most incident in patients with progressing and relapsing chronic lymphoid leukemia. The incidence of myelofibrosis was higher in patients with multiple myeloma and chronic lymphoid leukemia progression and relapses and in patients with chronic myeloid leukemia without hematological response than at the disease debut and in case of response to chemotherapy. The response to chemotherapy in patients with chronic myeloid leukemia and chronic lymphoid leukemia was associated with a decrease in the incidence of myelofibrosis. In patients with multiple myeloma responding to chemotherapy, the incidence of myelofibrosis did not change in comparison with the disease debut.