Blood, 1950, Vol. 5, No. 4, pp. 329-347.
© 1950 American Society of Hematology, Inc.
CHRONIC MARROW FAILURE, MYELOSCLEROSIS AND
EXTRAMEDULLARY HEMATOPOIESIS
JOHN P. WYATT M.D.1 and
SHELDON C. SOMMERS M.D.1
1 Laboratories of Pathology of the New England Deaconess Hospital, and the Harvard
Cancer Commission, Boston, Mass.
Thirty cases, including 20 autopsied, of chronic bone marrow failure, myelosclerosis and osteosclerosis have been presented and compared with similar reports
in the literature. The bone marrow histopathologic sequence observed involved
repeated necrobiosis of maturing hematopoietic cells, followed by overgrowth of
marrow reticulum and frequent ossification. Immature erythrocytes and leukocytes
were often found in the circulation, and extrameduallary hematopoiesis was characteristic. One case was complicated by leukemia. Etiologic factors implicated
included exogenous toxic chemicals, liver dysfunction, endocrine abnormalities,
blood loss or destruction and cardiovascular disease. Suspicion was directed toward
the pathogenetic importance of protracted bone marrow exposure to certain substances normally conjugated rapidly in the liver and excreted.
Note:
ACKNOWLEDGMENT
The authors acknowledge gratefully the continued assistance of Dr. John Norcross and Dr. Donat
P. Cyr of Lahey Clinic, Boston, who permitted use of material from living cases.
We are indebted to Dr. Shields Warren, New England Deaconess Hospital, Boston, for permission
to review 10 cases; to Dr. Olive Gates, Harvard Medical School, for advice and assistance with 7 cases,
including material from the Collis P. Huntington Hospital; to Professor William Boyd for 5 cases from
Banting Institute, Toronto; to Dr. Paul D. Rosahn, New Britain General Hospital, New Britain, Conn.,
and Dr. William Dameshek for one case; to Dr. A. J. Blanchard for several cases from Christie St. Hospital, Toronto; to Drs. Lorne Whittaker and Sabin of St. Catherine’s Hospital for one case; and to Dr.
John Brownlee for hematologic studies from one case.
