Skip to main content
SpringerLink
Log in

Bone marrow MR imaging as predictors of outcome in hemopoietic stem cell transplantation

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The purpose of this study is to investigate the role of femoral marrow MR imaging as predictor of outcome for hemopoietic stem cell transplantation (HSCT) in beta-thalassemia major. MR imaging of the proximal femur, including T1- and T2-weighted spin echo and short-tau inversion recovery and in-phase and out-of-phase fast field echo images, was prospectively performed in 27 thalassemia major patients being prepared for HSCT. The area of red marrow and its percentage of the proximal femur were measured, and the presence of marrow hemosiderosis was assessed. Age-adjusted multivariate logistic regression was used to determine the relationship between red marrow area percentage and marrow hemosiderosis and HSCT outcome. Red area percentage were less in patients with successful (90.25 ± 4.14%) compared to unsuccessful transplants (94.54% ± 2.93%; p = 0.01). Red marrow area percentage correlated positively with duration of symptoms(r = 0.428, p = 0.026) and serum ferritin (r = 0.511, p = 0.006). In multivariate-adjusted logistic regression analyses, red marrow area percentage was significantly inversely associated with successful HSCT (OR = 1.383, 95% CI: 1.059–1.805, p = 0.005). Marrow hemosidersosis and duration of sympotms and serum ferritin were not associated with HSCT outcome(p = 0.174, 0.974, 0.762, respectively). Red marrow area percentage of proximal femur on MR imaging is a useful predictor of HSCT outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lucarelli G, Galimberti M, Polchi P, Angelucci E, Baronciani D, Giardini C, Politi P, Durazzi SM, Muretto P, Albertini F (1990) Bone marrow transplantation in patients with thalassemia. N Engl J Med 322:417–421

    PubMed  CAS  Google Scholar 

  2. Lucarelli G, Clift RA, Galimberti M, Angelucci E, Giardini C, Baronciani D, Polchi P, Andreani M, Gaziev D, Erer B, Ciaroni A, D’Adamo F, Albertini F, Muretto P (1999) Bone marrow transplantation in adult thalassemic patients. Blood 93:1164–1167

    PubMed  CAS  Google Scholar 

  3. Gaziev D, Galimberti M, Lucarelli G, Polchi P, Giardini C, Angelucci E, Baronciani D, Sodani P, Erer B, Biagi MD, Andreani M, Agostinelli F, Donati M, Nesci S, Talevi N (2000) Bone marrow transplantation from alternative donors for thalassemia: HLA-phenotypically identical relative and HLA-nonidentical sibling or parent transplants. Bone Marrow Transplant 25:815–821

    Article  PubMed  CAS  Google Scholar 

  4. Lawson SE, Roberts IA, Amrolia P, Dokal I, Szydlo R, Darbyshire PJ (2003) Bone marrow transplantation for beta-thalassaemia major: the UK experience in two paediatric centres. Br J Haematol 120:289–295

    Article  PubMed  Google Scholar 

  5. Lucarelli G, Galimberti M, Polchi P, Angelucci E, Baronciani D, Giardini C, Andreani M, Agostinelli F, Albertini F, Clift RA (1993) Marrow transplantation in patients with thalassemia responsive to iron chelation therapy. N Eng J Med 329:840–844

    Article  CAS  Google Scholar 

  6. Lucarelli G, Clift RA, Galimberti M, Polchi P, Angelucci E, Baronciani D, Giardini C, Andreani M, Manna M, Nesci S, Agostinelli F, Rapa S, Ripalti M, Albertini F (1996) Marrow transplantation for patients with thalassemia: results in class 3 patients. Blood 87:2082–2088

    PubMed  CAS  Google Scholar 

  7. Giardini C, Galimberti M, Lucarelli G (1995) Bone marrow transplantation in thalassemia. Annu Rev Med 46:319–330

    Article  PubMed  CAS  Google Scholar 

  8. Sodani P, Gaziev D, Polchi P, Erer B, Giardini C, Angelucci E, Baronciani D, Andreani M, Manna M, Nesci S, Lucarelli B, Clift RA, Lucarelli G (2004) New approach for bone marrow transplantation in patients with class 3 thalassemia aged younger than 17 years. Blood 104:1201–1203

    Article  PubMed  CAS  Google Scholar 

  9. Lucareli G, Andreani M, Angelucci E (2002) The cure of thalassemia by bone marrow transplantation. Blood Rev 16:81–85

    Article  Google Scholar 

  10. Vande Berg BC, Malghem J, Lecouvet FE, Maldague B (2001) Normal bone marrow: dynamic aspects in magnetic resonance imaging. J Radiol 82:127–135

    Google Scholar 

  11. Vande Berg BC, Malghem J, Lecouvet FE, Maldague B (1998) Magnetic resonance imaging of normal bone marrow. Eur Radiol 8:1327–1334

    Article  Google Scholar 

  12. Vande Berg BC, Malghem J, Lecouvet FE, Maldague B (1998) Classification and detection of bone marrow lesions with magnetic resonance imaging. Skeletal Radiol 27:529–545

    Article  Google Scholar 

  13. Vande Berg BC, Lecouvet FE, Michaux L, Ferrant A, Maldague B, Malghem J (1998) Magnetic resonance imaging of the bone marrow in hematological malignancies. Eur Radiol 8:1335–1344

    Article  Google Scholar 

  14. Tunaci M, Tunaci A, Engin G, Ozkorkmaz B, Dinçol G, Acunaş G, Acunaş B (1999) Imaging features of thalassemia. Eur Radiol 9:1804–1809

    Article  PubMed  CAS  Google Scholar 

  15. Levin TL, Sheth SS, Ruzal-Shapiro C, Abramson S, Piomelli S, Berdon WE (1995) MRI marrow observations in thalassemia: the effects of the primary disease, transfusional therapy, and chelation. Pediatr Radiol 25:607–613

    Article  PubMed  CAS  Google Scholar 

  16. Muretto P, Del Fiasco S, Angelucci E, De Rosa F, Lucarelli G (1994) Bone marrow transplantation in thalassemia: modifications of hepatic iron overload and associated lesions after long-term engrafting. Liver 14:14–24

    PubMed  CAS  Google Scholar 

  17. Gandon Y, Guyader D, Heautot JF, Reda MI, Yaouanq J, Buhé T, Brissot P, Carsin M, Deugnier Y (1994) Hemochromatosis: diagnosis and quantification of liver iron with gradient-echo MR imaging. Radiology 193:533–538

    PubMed  CAS  Google Scholar 

  18. Merkle EM, Nelson RC (2006) Dual gradient-echo in-phase and opposed-phase hepatic MR imaging: a useful tool for evaluating more than fatty infiltration or fatty sparing. Radiographics 26:1409–1418

    Article  PubMed  Google Scholar 

  19. Amano Y, Onda M, Amano M, Kumazaki T (1997) Magnetic resonance imaging of myelofibrosis. STIR and gadolinium-enhanced MR images. Clin Imaging 21:264–268

    Article  PubMed  CAS  Google Scholar 

  20. Moore SG, Dawson KL (1990) Red and yellow marrow in the femur: age-related changes in appearance at MR imaging. Radiology 175:219–2232

    PubMed  CAS  Google Scholar 

  21. Vande Berg BC, Lecouvet FE, Moysan P, Maldague B, Jamart J, Malghem J (1997) MR assessment of red marrow distribution and composition in the proximal femur: correlation with clinical and laboratory parameters. Skeletal Radiol 26:589–596

    Article  Google Scholar 

  22. Hajek PC, Baker LL, Goobar JE, Sartoris DJ, Hesselink JR, Haghighi P, Resnick D (1987) Focal fat deposition in axial bone marrow: MR characteristics. Radiology 162:245–249

    PubMed  CAS  Google Scholar 

  23. Babyn PS, Ranson M, McCarville ME (1998) Normal bone marrow: signal characteristics and fatty conversion. Magn Reson Imaging Clin N Am 6:473–495

    PubMed  CAS  Google Scholar 

  24. Drakonaki EE, Maris TG, Papadakis A, Karantanas AH (2007) Bone marrow changes in beta-thalassemia major: quantitative MR imaging findings and correlation with iron stores. Eur Radiol 17:2079–2087

    Article  PubMed  Google Scholar 

  25. Anasetti C, Etzioni R, Petersdorf EW, Martin PJ, Hansen JA (1995) Marrow transplantation from unrelated volunteer donors. Ann Rev Med 46:169–179

    Article  PubMed  CAS  Google Scholar 

  26. Sebag GH, Moore SG (1990) Effect of trabecular bone on the appearance of marrow in gradient-echo imaging of the appendicular skeleton. Radiology 174:855–859

    PubMed  CAS  Google Scholar 

  27. Techawiboonwong A, Song HK, Magland JF, Saha PK, Wehrli FW (2005) Implications of pulse sequence in structural imaging of trabecular bone. J Magn Reson Imaging 22:647–655

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Second Affiliated Hospital, Sun Yat-sen University, 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, People’s Republic of China

    Jun Shen, Li-Na Cheng, Xiao-Hui Duan & Bi-Ling Liang

  2. Department of Pediatrics, Second Affiliated Hospital, Sun Yat-sen University, 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China

    Hong-Gui Xu

  3. Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing St, Shatin, Hong Kong SAR, China

    James F. Griffith

Authors
  1. Jun Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James F. Griffith
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Li-Na Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiao-Hui Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bi-Ling Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong-Gui Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jun Shen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shen, J., Griffith, J.F., Cheng, LN. et al. Bone marrow MR imaging as predictors of outcome in hemopoietic stem cell transplantation. Eur Radiol 18, 1884–1891 (2008). https://doi.org/10.1007/s00330-008-0953-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-008-0953-6

Keywords

Search

Navigation