BACKGROUND: Bone marrow scintigraphy using Tc-99m labeled antigranulocyte antibody has been reported to be able to evaluate bone marrow status. We have performed antigranulocyte antibody scan and hematopoietic activity in order to identify bone marrow status in patients with hematologic diseases. METHODS: Sixty-nine patients were enrolled in this study from October 1995 to May 1997. Images were acquired at four and twenty-four hour after injecion of 20mCi 99mTc labeled antigranulocyte antibody (BW 250/183). Patients were divided into four groups according to scintigraphic findings, those with increased marrow uptake (marrow expansion), decreased uptake, focal defect and normal findings. RESULTS: Leukemias and myelodysplastic syndromes frequently showed bone marrow expansion. Seventeen of 21 patients (81%) with AML, and all of ALL and biphenotypic leukemias showed bone marrow expansion. Five of 6 with CML, all Hodgkin's diseases and 3 of 4 MDS also showed marrow expansion. In contrast, all aplastic anemia patients showed decreased marrow uptake, and extra-axial noted in 2 patients with aplastic anemia. All of ten patients with multiple myeloma and 2 of 4 (50%) with Hodgkin disease showed focal marrow defects. Three of 11 with non-Hodgkin lymphoma and 4 of 21 with AML also showed focal marrow defects. CONCLUSION: Bone marrow scintigraphy using antigranulocyte antibody has clearly demonstrated the distribution of bone marrow in various hematologic diseases. Thus, it seems to be a useful method in the assessment of bone marrow status in patients with hematologic disease.