Bone Marrow Findings in Lupus Patients with Pancytopenia

The marrow findings of 23 lupus patients with pancytopenia were reported. The most common findings were dyserythro-poiesis and hypoplasia, both occurrinq in 9/23 (39%) of the cases. Neither feature was definitively related to cytotoxic drug therapy since some cases were only treated by steroids and two cases were never treated. 3 of the hypoplastic marrows also had gelatinous transformation, a condition characterized by disruption of marrow architecture, fat atrophy, and deposition of hyaluronic acid. Another common finding was lymphocytosis which occurred in 5/23 (72%) of the cases, 2 of which also had associated plasmacytosis. 2 cases were associated with hyperplastic marrow (cellularity >70%), indicatinq peripheral destruction of blood cells and compensatory marrow hyperplasia. Reports in the literature on bone marrows in systemic lupus erythematosus were conflictinq, describinq mainly hypoplasia, vasculitis, and piasmacytosis. In our series, we described hypoplasia and lymphocytosis/plasmacytosis; in addition we described findings heretofore unreported: gelatinous transformation, dyserthropoeisis, and marrow hyperplasia.