Management of Allogeneic Stem Cell Transplantation for High-Risk AML following SARS-CoV-2 Associated Pancytopenia with Marked Bone Marrow Biopsy Alterations

Figure 1

Bone marrow biopsy findings before and after COVID-19 diagnosis. (a) Before SARS-CoV-2 detection, all three main hematopoietic lineages were visible. There was no significant dysplasia. Erythroid cells were relatively scant and scattered. There was subtle stromal damage. (b) Following SARS-CoV-2 infection, prominent erythroid hyperplasia and signs of stromal damage were observed. Large clusters of erythroid cells were locally synchronised at the same maturational stage (“stress erythropoiesis”). Proerythroblasts showed megaloblastoid features. Erythroid cells approached the trabecular bone. (c) An excess of stromal histiocytes on CD163 immunostaining after SARS-CoV-2 infection. (d) On CD61 immunostaining, profound megakaryocytic deficit and atypia were illustrated after SARS-CoV-2 infection.

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