THE LOCAL BLOOD FLOW IN HUMAN BONE MARROW IN LEUKEMIA AND NEOPLASTIC DISEASES AS DETERMINED BY THE CLEARANCE RATE OF RADIOIODIDE (I131) 1

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Abstract
The Kety radioisotope clearance technique with l131 was applied to a study of bone marrow and muscle blood flow in 43 patients with various neoplastic diseases, lymphoblastomas, and leukemias. The marrow clearance rates were found to be approx. the same as resting muscle in all 17 of the non-leukemic patients studied. In 5 cases of acute leukemia, marrow clearance rates were increased, being 2-3 times greater than the rate observed in the non-leukemic group, whereas, in 5 of 7 patients with chronic myelocytic leukemia, and in 2 cases of monocytic leukemia, the marrow clearance rates were within the range of the non-leukemic group of patients. In 6 of 10 patients with chronic lymphocytic leukemia, elevated clearance rates were obtained. Three out of 4 patients with multiple myeloma had increased marrow clearance rates. When marrow K to muscle K ratios were obtained in the non-leukemic, chronic myelocytic and monocytic leukemic patients, the values fell below 1.4. In 2 cases of acute leukemia and 4 of 10 chronic lymphocytic leukemics the ratio obtained was well above 1.4. The findings appear to demonstrate a selective increase in blood flow in the bone marrow in acute leukemia and in some cases of chronic lymphocytic leukemia and multiple myeloma, and strongly suggest that fundamental differences in the marrow vascular bed exist among the leukemic group of diseases. Alterations were produced in the clearance rates in bone marrow following the intravenous injn. of Paredrine and hexamethonium in 2 patients. The radioisotope clearance technique promises to be a useful tool for the investigation of the pathologic physiology of the human bone marrow circulation.