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Forum Name: Leukemia

Question: Mature vs. immature cells in bone marrow


 bluetopaz - Tue Mar 31, 2009 7:53 am

If bone marrow is hypercellular, with mature cells as opposed to immature ones, would this indicate MDS or leukemia? I seem to have read that the immature forms are mostly found in MDS, whereas in leukemia the cells might be more mature. The peripheral blood is rather borderline deficient in all cells lines.
 Dr. Tamer Fouad - Sun Sep 06, 2009 8:31 am

User avatar Hello,

To comment on the cellularity of the bone marrow aspirate alone would be nonspecific. Hypercellular marrow can occur in many circumstances including normal conditions as well as in certain types of benign diseases, and malignant ones. Determining cellularity is very important in the diagnosis of malignant blood diseases because the percentage of malignant cells must be reported in relation to the cellularity for correct estimation and diagnosis of the disease.

A lot of other changes in the bone marrow are important when diagnosing malignant blood diseases. All these factors are taken together as there is no single test that can tell you right away what the diagnosis is.

Regarding your question about immature cells: certain types of leukemias e.g. the acute leukemias have immature malignant cells while chronic leukemias have more mature malignant cells. It really depends on the stage of development at which the blood generating cell undergoes malignant transformation.

MDS may show immature cells (up to 20% blast cells, immature red cells) as well as abnormal mature cells (dysplastic).

Malignant hematological diseases are complicated and therefore not always easy to understand. I hope that helps.

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