A VARIANT OF GELATINOUS TRANSFORMATION OF MARROW IN LEUKEMIC PATIENTSPOSTCHEMOTHERAPY

A variant of gelatinous transformation of marrow was described in leuk emic patients post-chemotherapy. This lesion was found in 8 out of 183 3 post-chemotherapy bone marrows from 429 patients with leukemia. Hist ologically, this variant form was identical to the classical gelatinou s transformation except for the absence of fat atrophy. In marrow smea rs, mucoid strands were seen between marrow particles and oriented alo ng the direction of spread. In clot and trephine sections, an eosinoph ilic ground substance was widespread, filling out spaces around the fa t cells, which occupied the normal proportion of marrow space. At high magnification, this ground substance appeared granular and fibrillary , a non-specific feature which could also be seen in fibrin clot commo nly found in marrow sections. This eosinophilic ground substance, howe ver, can be distinguished from fibrin clots by positive staining with Alcian Blue (pH 2.3) and inhibition of the staining after treatment wi th hyaluronidase. Clinically, in contrast to the classical form, this variant form of gelatinous transformation was acute in onset, transien t, and associated with chemotherapy but not with cachexia.