The predicting role of substance P in the neoplastic transformation of the hypoplastic bone marrow

J Clin Pathol. 2006 Sep;59(9):935-41. doi: 10.1136/jcp.2005.034629.


Aims: To estimate the expression of substance P in the haematopoietic cells of hypoplastic bone marrow and define its relationship with the course of bone marrow hypoplasia.

Methods: Bone marrow specimens were obtained from 42 children with bone marrow hypoplasia who were hospitalised in the Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland, between 1996 and 2003. Substance P and Ki-67 expression were evaluated using immunochemical and hybridocytochemical assays.

Results: The expression of substance P (as evidenced by both immunocytochemical and hybridisation techniques) was confirmed in the cytoplasm of B lymphocytes in 8 of 11 children who developed acute leukaemia in 45 (SD 12) days. The percentage of substance P-positive cells ranged from 67.6 to 95.8 (mean of 81.5% cells with immunocytochemistry and 84.3% with in situ hybridisation). The risk of development of leukaemia secondary to bone marrow hypoplasia was found to be significant (p<0.001) in those children who expressed substance P in normal-looking lymphocytes at the initial bone marrow evaluation.

Conclusions: The presence of substance P in B lymphocytes of hypoplastic bone marrow may predict its neoplastic transformation. A marked correlation between substance P-positive bone marrow pattern and the expansion of tumour cells may prove the potential value of this oligopeptide in the pathogenesis of leukaemia.

MeSH terms

  • Adolescent
  • B-Lymphocytes / metabolism
  • Bone Marrow Diseases / metabolism*
  • Bone Marrow Examination / methods
  • Cell Transformation, Neoplastic / metabolism*
  • Child
  • Child, Preschool
  • Disease Progression
  • Humans
  • Immunoenzyme Techniques
  • Immunophenotyping
  • In Situ Hybridization
  • Ki-67 Antigen / metabolism
  • Leukemia / metabolism*
  • Leukemia, Myeloid, Acute / metabolism
  • Neoplasm Proteins / metabolism
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / metabolism
  • Prognosis
  • Substance P / metabolism
  • Substance P / physiology*


  • Ki-67 Antigen
  • Neoplasm Proteins
  • Substance P