Extramedullary haemopoiesis after bone marrow transplantation

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Abstract
Patients (44) underwent bone marrow transplantation (BMT) for treatment of severe aplastic anemia of hematological malignancies. During their post-transplant phase all patients had erythroblasts and granulocytic precursors in their peripheral blood. Patients (15) died between day + 6 and d + 346 after BMT and autopsies were performed. The sections of all 15 patients revealed extramedullary hemopoiesis in the spleen. Extramedullary hemopoiesis in the liver was found only in those patients who died early (between d + 6 and d + 21 after BMT). Medullary hemopoiesis, normally only occurring in the vertebral body, was also observed in the shaft of the femur. After BMT all tissues with a hemopoietic matrix in ontogenesis can be repopulated with hemopoiesis in the early phase of reconstitution, possibly to compensate for the hemopoietic insufficiency after conditioning therapy. The expansion of hemopoiesis in the later period of up to 1 yr after BMT, remains to be explained.