A Rare Episode of Extensive Bone Marrow Necrosis in a Chemotherapy-naïve Patient with Multiple Myeloma Exhibiting TP53 and TET2 Mutations.

ABSTRACT

Bone marrow necrosis (BMN) is a rare life-threatening condition in which the marrow is replaced by necrotic material. Half of BMN occurrences are attributed to chemotherapy or granulocyte-colony stimulating factor treatment in patients with hematolymphoid malignancies. However, we present a patient diagnosed with both multiple myeloma and extensive BMN despite being treatment-naïve. Our patient exhibited a TP53 deletion, TET2 frameshift mutation, and a single TET2 nucleotide change. He is the third such patient reported, but the first to have his cytogenetic and molecular genetic profiles investigated using conventional cytogenetics, fluorescence in situ hybridization, and next-generation sequencing.