Haemophagocytosis in Bone Marrow Aspirates

Prof. Durjoy K. Shome, MD, Department of Pathology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi 110002 (India), Tel. 3239546 In the paper entitled ‘Haemophagocytosis in Bone Marrow Aspirate – A Review of the Clinical Course of 10 Cases, Linn et al. [1] analysed 10 cases of haemophagocytosis seen in marrow. The authors observed that 8 patients had a classical haemophagocytic syndrome and an unusually high number (6 cases) had confirmed lymphoma. Haemophagocytosis occurs in a wide variety of clinical conditions. The diagnosis of the syndrome, however, requires the fulfilment of some additonal clinical and laboratory criteria [2, 3]. Since 1993, as a result of our collective work at two large referral hospitals (Maternity and Children Hospital at Jeddah, Saudi Arabia and Maulana Azad Medical College at New Delhi, India), prominent haemophagocytosis was seen in 14 cases whereas the classical syndrome was diagnosed in 3 (table 1). Ten of these cases were observed in association with a variety of infections, some of which are commonly diagnosed at these hospitals, namely malaria, enteric fever and tuberculosis. Linn et al. have not submitted data to show that all the criteria advocated by the Histiocyte Society for the diagnosis of a haemophagocytic syndrome were met. Hyper-triglyceridaemia occurs consistently in familial haemophagocytic lymphohistiocytosis Table 1. Diseases associated with haemophagocytosis with or without haemophagocytic syndrome