USEFULNESS OF BONE-MARROW INVESTIGATION I N PATIENTS WITH ADVANCED HIV-INFECTION

A bone marrow investigation is a common examination in HIV infected pa tients for the study of cytopenia, febrile syndromes of unknown origin and extension of neoplastic disorders. A study was made of bone marro w specimens from 35 patients with advanced HIV infection (stage IC or C, CDC, Atlanta) for morphologic and culture investigations (aerobes, anaerobes, fungi, and mycobacteria). In nine patients cytopenia accoun ted for the investigation of bone marrow specimens (9 aspirates and 3 biopsies); in only two cases did the investigation orientate towards a possible etiology: in the first patient a parvovirus B19 infection an d in the second patient a hemophagocytic syndrome. In twenty-five pati ents the bone marrow specimen was studied because of fever of unknown origin (23 aspirates and 10 biopsies) and only in one case was the ide ntification of Mycobacterium tuberculosis obtained. The other patient was studied for lymphoma staging and aspirate and biopsy examinations were normal. A high percentage of patients had eosinophilia, plasmacyt osis, increased iron reserves, fibrosis, and changes consistent with m yelodysplasia. In conclusion, in our experience the investigation of b one marrow specimen was of little help to clarify the possible etiolog y of cytopenia and febrile syndromes of unknown origin in patients wit h advanced HIV infection.