Occult bone marrow involvement in patients with diffuse large B-cell lymphoma: results of a pilot study
Date
2007
Authors
Talaulikar, Dipti
Shadbolt, Bruce
McNiven, Michelle
Broomfield, Amy
Pidcock, Michael
Dahlstrom, Jane
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis Group
Abstract
Aims: It is known that advanced stage disease in diffuse large B-cell lymphoma (DLBCL) confers a poor prognosis, and staging investigations are routinely performed at diagnosis, including a bone marrow (BM) biopsy. However, examination of the BM is usually limited to routine light microscopy, with the role of ancillary investigations remaining unestablished. The aim of this pilot study was to estimate the incidence of occult marrow involvement using flow cytometry, immunohistochemistry and immunoglobulin heavy chain (IgH) gene rearrangements, and to determine the impact on survival. Methods: Clinical and pathological data were obtained on 36 patients diagnosed with DLBCL. Immunohistochemistry using CD3, CD45RO, CD20 and CD79a, and polymerase chain reaction (PCR) to look for IgH gene rearrangements were performed on formalin fixed BM trephines. Results: Nine patients had morphologically apparent BM involvement. Occult marrow involvement was found in seven of 36 (19.4%) patients using the additional diagnostic modalities. When these cases were included with morphologically apparent cases in a proposed new definition of marrow involvement, the median survival of patients with BM involvement was statistically worse (p = 0.02) than those without involvement. Conclusions: The results indicate that use of additional tests on BM at diagnosis can upstage disease for a proportion of patients, which appears to correlate adversely with survival.
Description
Keywords
Keywords: anthracycline derivative; cyclophosphamide; doxorubicin; prednisone; vincristine; adult; aged; article; B cell lymphoma; bone marrow; bone marrow biopsy; cancer staging; clinical article; clinical feature; combination chemotherapy; controlled study; disea Bone marrow; Diffuse large B-cell lymphoma; Flow cytometry; Immunoglobulin heavy chain gene rearrangement; Immunohistochemistry; Staging
Citation
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Source
Pathology
Type
Journal article
Book Title
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DOI
10.1080/00313020701684417
Restricted until
2037-12-31