抗白血病剤により無形成となった白血病骨髄の病理組織学的研究
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概要
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A histopathological study was performed on the 36 autopsy cases of myeloid leukemia (30 acute cases, 6 chronic ones) with aplastic bone marrow due to the administration of the so-called antileukemic agents (steroid hormone, 6 MP, Busulphan etc. ) . The following results were obtained.<BR>1) The findings of the bone marrows are classified into 4 types;<BR>Type A : Bone marrow with severe desolation.<BR>13 acute cases and 2 chronic ones.<BR>Type B : Bone marrow substituted by fat tissue.<BR>7 acute cases and 2 chronic ones.<BR>Type C : Bone marrow with regeneration of normal hemopoiesis.<BR>7 acute cases and 1 chronic one.<BR>Type D : Bone marrow with marked fibrosis.<BR>3 acute cases and 1 chronic one.<BR>Their histogenesis is discussed briefly in each type.<BR>2) Bone marrows of type B and C are much simillar to that of aplastic anemia and especially the marrow substituted by fat tissue is very much simillar to the so-called fundamental type of aplastic anemia, therefore the painstaking detection of the leukemic infiltration in the other organs and the remain of the leukemic cells in bone marrow is urgently needed for the sake of the differential diagnosis.<BR>Furthermore, it goes without saying that clinical course, blood pictures and marrow smears play an important role in making final diagnosis.<BR>3) Except few cases, there are no histological differences in the different site of bone marrow. Even in such few cases, only slight discrepancy is noted about hemopoietic cell content among the various sites of bone marrow.<BR>4) In 21 cases of 30 acute one and in 5 cases of 6 chronic ones, some rest of leukemic cells is discernible in the aplastic bone marrow induced by antileukemic agents. In those cases which show some rest of leukemic cells in bone marrow, the frequency of the leukemic infiltration to other organs is higher than that in the cases which show no leukemic infiltration in bone marrow.<BR>5) Even in cases with leukemic infiltration to other organs, its degree is not so marked except testis.<BR>6) Any apparent relationship can not be clarified between the kinds of antileukemic agents and its histopathological influence to bone marrow structure.<BR>7) The average survival periods of acute 30 cases are 5.9 months. There seems to be some effect of lif e-extention by the antileukemic agents. In acute cases the average survival in each type is 8.1 months in type B, 6.8 months in Type C, 4.6 months in Type A and 3.3 months in Type D. But the decisive conclusion remains obscure and further studies on this problem are necessary.
- 学校法人 昭和大学・昭和医学会の論文