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Summary Bone Marrow - Single Chapter

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This chapter contains notes on bone marrow (strictly relevant to hematology). This document is an excellent companion to the chapter on hematopoiesis available in my store. Topics include but are not limited to bone marrow composition, function, relevant bone marrow laboratory procedures, stem cell...

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  • June 22, 2024
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  • 2023/2024
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MedicalTech
BONE MARROW

BONE MARROW FUNCTION

Bone marrow, as discussed is the hematopoiesis section, plays an integral
role in the production, maturation, and maintenance of blood cells. It can
also be a good indicator of blood-related disorders and diseases.
 Colony-stimulating factors influence stem cell differentiation within
the bone marrow
 CSFs are produced from certain ells after exposure to monocyte
interleukin (IL-1) and tissue necrosis factor (TNF)
BONE MARROW STRUCTURE AND COMPONENTS
 Artery enters bone and branches to the periphery area called
sinuses
 Several sinuses join to make a collecting sinus
 This becomes a central vein that returns into systemic circulation
 Hematopoiesis occurs in hematopoietic cords
 Cords lie outside the sinuses
 After maturation, cells cross the walls of sinuses to enter circulation

BONE MARROW IRON STORES
 Storage of iron in bone marrow is hemosiderin
 Has higher content than ferritin
 Appears as brownish bluish granules on Wright-Giemsa-stained
smears
 Prussian Blue stain used to be more precise
 Hemosiderin and some ferritin granules are seen as bright blue
specks
o Hgb iron and dispersed ferritin do not stain

REPORTING IRON STORES
 When no stainable iron is detected on the bone marrow smear or
tissue it indicates iron storage depletion or absence
 This may be reported as:
o Absent
o Decreased
o Adequate
o Moderately increased
o Markedly increased
 Also can be reported numerically from 0-4 with 2 being normal
 In children, iron mainly stores as ferritin and does not stain with
Prussian Blue

,  Some derangements in iron metabolism result in aberrant ringing
around erythroblast nuclei-termed side oblasts

STEM CELLS IN BONE MARROW
 2 characteristics
o Self-renewal
o Multilineage differentiation
 Can be further subcategorized
o Pluripotent: gives rise to many different cell lines
o Committed (progenitor): dedicated to one lineage and cannot
self-renew
 Marrow stem cells are morphologically indistinguishable from small
lymphocytes
 bone marrow and thymus are primary lymphoid organs of antigen-
independent progenitor lymphoid cell proliferation

HEMATOGONES
 Committed to progenitor cells of lymphoid lineage
 Increased in normal infants, older children, and sometimes in adults
 May be increased in:
o neuroblastoma
o iron deficiency anemia
o idiopathic thrombocytopenic purpura (ITP)
 Resemble lymphoblastic leukemia
 Be aware of the conditions in which they occur
HEMATOLOGIC DISEASES
 Morphological abnormalities of peripheral blood cells
 Bone marrow should be interpreted alone with a peripheral smear
 Experienced hands and current needles should perform a biopsy,
which minimizes risks

INDICATIONS FOR BONE MARROW STUDIES
Biopsies of bone marrow are expensive and painful. It’s important to know
when it is indicated that the patient could benefit from the diagnostic results
of bone marrow analysis. Hematologic diseases affecting primarily the bone
marrow and causing an increase/decrease in any cellular blood element (or
more than one in the case of leukemias) are the basis for performing a bone
marrow biopsy.

Examples:
 Anemia
 Polycythemia

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