Core decompression with autologous bone marrow aspirate injection in humeral head osteonecrosis in adults with sickle cell disease

In an attempt to understand the variability of the hematologic response to oral sodium cyanate, iron metabolism was studied in a group of 39 patients with sickel cell disease. Eleven of the 39 patients were found to have no stainable iron in the marrow despite the fact that patients with sickle cell disease are generally considered to have hemosiderosis. The mean per cent saturation and total iron-binding capacity were in the low-normal range in sickle cell patients whether or not stainable iron was present in the bone marrow aspirate. Serum ferritin concentrations, on the other hand, were found to be high in both groups (greater than 500 mu g/liter) when compared to controls (60 mu g/liter). The high serum ferritin levels denoted significant total- body iron deposition which may be unavailable for normal metabolic processes. One patient with no stainable iron in the bone marrow aspirate did respond to iron therapy alone with an increase in hemoglobin concentration. Serum ceruloplasmin levels were also found to be high in sickle cell disease patients. The ability to respond to oral cyanate therapy was correlated with the amount of stainable iron in the bone marrow aspirate. These studies emphasize the necessity of a reevaluation of iron metabolism in the pathophysiology and treatment of sickle cell disease.

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Iron metabolism, sickle cell disease, and response to cyanate

Blood ◽

10.1182/blood.v46.4.583.583 ◽

1975 ◽

Vol 46 (4) ◽

pp. 583-590 ◽

Cited By ~ 26

Author(s):

CM Peterson ◽

JH Graziano ◽

A de Ciutiis ◽

RW Grady ◽

A Cerami ◽

...

Keyword(s):

Bone Marrow ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Serum Ferritin ◽

Iron Metabolism ◽

Bone Marrow Aspirate ◽

Binding Capacity ◽

High Serum ◽

Cell Disease ◽

Serum Ceruloplasmin

Abstract In an attempt to understand the variability of the hematologic response to oral sodium cyanate, iron metabolism was studied in a group of 39 patients with sickel cell disease. Eleven of the 39 patients were found to have no stainable iron in the marrow despite the fact that patients with sickle cell disease are generally considered to have hemosiderosis. The mean per cent saturation and total iron-binding capacity were in the low-normal range in sickle cell patients whether or not stainable iron was present in the bone marrow aspirate. Serum ferritin concentrations, on the other hand, were found to be high in both groups (greater than 500 mu g/liter) when compared to controls (60 mu g/liter). The high serum ferritin levels denoted significant total- body iron deposition which may be unavailable for normal metabolic processes. One patient with no stainable iron in the bone marrow aspirate did respond to iron therapy alone with an increase in hemoglobin concentration. Serum ceruloplasmin levels were also found to be high in sickle cell disease patients. The ability to respond to oral cyanate therapy was correlated with the amount of stainable iron in the bone marrow aspirate. These studies emphasize the necessity of a reevaluation of iron metabolism in the pathophysiology and treatment of sickle cell disease.

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Autologous Bone Marrow Mesenchymal Cell Transplantation in the Treatment of Freiberg's Disease: Case Report

Journal of Regenerative Biology and Medicine ◽

10.37191/mapsci-2582-385x-2(5)-042 ◽

2020 ◽

Author(s):

Paula Daltro

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Case Report ◽

Sickle Cell Disease ◽

Mesenchymal Stem Cell ◽

Autologous Bone Marrow ◽

Metatarsal Head ◽

Cell Disease ◽

Autologous Bone ◽

Freiberg’S Disease

Background: Osteonecrosis of the metatarsal head, classically known as Freiberg's disease, presents as aseptic necrosis of the epiphysis of undefined etiology, although it may be associated with trauma, prolonged corticotherapy or systemic diseases such as sickle cell disease. There are several techniques described for the treatment of osteonecrosis secondary to sickle cell disease. Methods: Case report and the surgical description of the use of autologous bone marrow mesenchymal stem cell transplantation for the treatment of osteonecrosis of the 2nd metatarsal head. Results: Nuclear magnetic resonance imaging performed after one year of follow-up showed a regression of the findings found in the preoperative evaluation. Conclusion: This is the first time that the technique of autologous bone marrow mesenchymal stem cell implantation has been employed for the treatment of osteonecrosis of the metatarsal head. The case reported shows that the technique is safe and brings good results after conservative treatment failure.

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