Bone marrow involvement in small cell lung cancer. Clinical significance and correlation with routine laboratory variables

Abstract

Of 129 patients with small cell lung cancer (SCLC) who underwent bone marrow examination for staging, 39 (30%) had bone marrow involvement. Only three of 129 patients (2.3%) had bone marrow involvement as the only site of metastatic disease. When patients with bone marrow metastasis were compared with patients whose bone marrow was normal, there were significant differences in serum levels of lactate dehydrogenase (LDH), glutamic oxalacetic transaminase (SGOT), glutamic pyruvic transaminase (SGPT), alkaline phosphatase (AP), albumin, and sodium (Na). We found no clinically significant difference in survival between patients with extensive disease with or without bone marrow involvement. Serum Na, albumin, SGOT, and uric acid were important prognostic determinants of survival. Based on the results of this study, we do not recommend routine bone marrow examinations in the staging of SCLC.

Bone Marrow Examination in Small Cell Lung Cancer—When Is It indicated?

“…This might be related to the relatively low number of patients in our study. However, some other authors have also failed to find a survival difference between these two groups of patients (4)(5)(6)17).…”

“…In various series, BM metastasis has been described in 6-45% ( I , 2). However, during the past few years the routine use of this test has been questioned, and several authors have found only a small percentage of patients (0-4%) in whom the stage or the treatment changed as a result of BM examination (3)(4)(5). Besides, when BM is infiltrated by SCLC cells neither prognosis nor tolerance of chemotherapy seems to be modified (4,5).…”

“…In SCLC, in contrast to most solid tumours, BM involvement is rarely associated with alterated blood count or immature cells in peripheral blood (4)(5)(6). Nevertheless, a relationship has been reported with elevated serum lactic dehydrogenase (LDH) (7,8), alterations of other biochemical parameters (5) or bone metastasis (8,9).…”

“…Nevertheless, a relationship has been reported with elevated serum lactic dehydrogenase (LDH) (7,8), alterations of other biochemical parameters (5) or bone metastasis (8,9).…”

Pseudocholinesterase, aspartate transaminase, alanine transaminase as markers for cervical cancer: a study in a tertiary care hospital

“…24 Similar increase in these enzyme levels were seen in similar studies on various cancer patients, such as breast cancer, gall bladder cancer prostate and lung cancer. [25][26][27][28] AST would be a significant and valuable prognostic factor for the survival duration of advanced cancer patients. Hui-Ju Tsai study revealed that two times higher AST and ALT levels, prolonged PT, and hypoalbuminemia are likely to be prognostic factors of poor survival in advanced cancer patients.…”