Blood and bone marrow findings in angioimmunoblastic lymphadenopathy.

The blood and bone marrow smears and sections of 38 patIents with angloimmuno. blastic lymphadenopathy (AILD) were examined and their hematologic data were reviewed. A normochromic normocytic anemia was found in 84% of patients. A positive direct Coombs’ test was noted in one-third of the patients tested. Leuko.. cytosis with neutrophilia and/or eoslnophilia were observed frequently. Lympho.. cytopenia of various degrees was evident in 79% of the patients, and circulating immunocytes were seen in 31%. Bone marrow smears were usually hypercellular with myelocytic or erythrocytic hyperplasia and a shift to the left. They also revealed a decrease in the small matureappearing lymphocytes in 61% and an increase in immunocytes in 65% of the patients. None of the abnormalities in the cellular components of the blood and of the bone marrow smears were diagnostic of AILD. However, lesions diagnostic of AILD were found in 70% of 27 patients in whom sections of bone marrow core biopsies or spicules were available. These lesions were similar to those described in lymph nodes; they were usually focal and occasionally diffuse. The cellular abnormalities in the blood did not necessarily coincide with the presence of histologically demonstrable AILD lesions in bone marrow biopsies. However, when the bone marrow biopsies showed the lesions diagnostic of AILD, the bone marrow smears usually contained an increased number of immunocytes. Th. involvement of bone marrow by lesions diagnostic of AILD could not be correlated with clinical progression or length of survival.