|A Bone Marrow Biopsy (BMB), though not essential for diagnosing Chronic Myeloid Leukemia (CML) in chronic phase, remains a firstline investigation in the work-up, prognostication and follow-up of this disorder. It demonstrates histological and topographic features, proliferation patterns, detects CML metamorphosis and fibrosis and is indispensable in the investigation of unexplained cytopenias during therapy.
Busalfan promotes myelofibrosis while hydroxyurea prevents it in a significant number of patients. In a study on 363 BMBs taken sequentially before and after allogeneic bone marrow transplantation, there was a significant correlation of marrow fibrosis, CD61+ cells and peripheral blood platelet counts with delayed haemopoietic reconstitution and leukemic relapse.
Prashant Sharma, Bone Marrow Histology in CML: A Continuing Relevance