Bone Marrow Metastases from Solid Organ Cancer in Adults

Arya, L. S.; Sundriyal, Deepak; Bhandari, Rajiv; Srivastava, Ruchi; Sehrawat, Amit

doi:10.1007/s13193-021-01377-7

Cited by 5 publications

(9 citation statements)

References 11 publications

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“…19 Furthermore, because BM causes bone pain or elevation in alkaline phosphatase (ALP) levels 20 and because BMM was diagnosed simultaneously with or after BM, the relationship between bone pain or ALP level elevation in patients and BC with BMM needs further exploration, which was different from the investigation in previous studies. 6,7,9 The most common clinical manifestations observed in the present study were the coexistence of anemia and thrombocytopenia, followed by anemia only, and pancytopenia. Cases of Grade 3 or higher leukopenia were rare at 3.0% (2/67), and a diagnosis of BMM with leukopenia only was also rare at 3.0% (2/67).…”

Section: Characteristicsmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

“… 4 However, bone marrow aspiration smear and trephine biopsy are not routine clinical practices. Hence, the early diagnosis of BMM is limited by the lack of specific clinical manifestations 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 and is easily overlooked by clinicians.…”

Section: Introductionmentioning

confidence: 99%

“…Most patients diagnosed with late‐stage BMM may lose the opportunity to receive the normal dose and course of radiation and chemotherapy, which leads to a reduction in their survival. 3 , 5 , 6 , 7 , 8 , 9 , 10 In addition, patients with symptomatic BMM have been excluded from previous clinical trials on BC. Thus, given the paucity of data in this area, the appropriate treatment of BC with BMM is not discussed in detail in the major guidelines.…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathological features and prognosis of breast cancer combined with symptomatic bone marrow metastases: A 10‐year, single‐center, real‐world study of 67 cases

Niu

Zhang

et al. 2023

Cancer Medicine

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Purpose Bone marrow metastasis (BMM) is uncommon in breast cancer (BC), and early diagnosis is challenging. BMM lacks definitive treatment options and poses a great threat to the survival of patients. Herein, we investigated the clinical features, prognosis, and factors affecting the prognosis of BC patients with symptomatic BMM to help improve the understanding of this disease and provide effective diagnostic and treatment strategies. Methods Clinical data of 67 patients with BC and BMM were retrospectively analyzed for clinical characteristics, treatment, and prognosis of BMM. Univariate and multivariate analyses were performed to determine factors affecting overall survival following BMM (BMMOS). Results Among patients with BMM, 86.6% were diagnosed after bone metastasis (BM), while 13.4% were diagnosed simultaneously with BM. A total of 73.1%, 13.4%, and 13.4% of the patients had hormone receptor‐positive/human epidermal growth factor 2‐negative (HR+/HER2−) tumors, HER2+ tumors, and triple‐negative tumors, respectively. The most common symptoms of BMM were the coexistence of anemia and thrombocytopenia (26.9%), anemia (19.4%), and pancytopenia (17.9%). The median BMMOS was 7.6 months (95% CI, 3.9–11.3). Univariate and multivariate analyses showed that BMMOS was associated with platelet count <75 × 109/L at the time of BMM diagnosis. The BMMOS of patients who underwent endocrine therapy, combined chemotherapy, and mono‐chemotherapy after BMM was 15.7, 9.7, and 8.6 months, respectively, whereas that of untreated patients was 2.9 months, and the difference among the results was statistically significant (χ2 = 20.102, p < 0.0001). Changes in patient hemogram and/or body temperature during treatment were consistent with the overall effect of the disease (p < 0.0001). Conclusion BMM should be considered in BC patients with BM, an unexplained reduction in hemogram parameters, especially anemia and thrombocytopenia, and/or fever without chills. Active, effective, individualized treatment strategies can prolong BMMOS.

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Section: Characteristicsmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinicopathological features and prognosis of breast cancer combined with symptomatic bone marrow metastases: A 10‐year, single‐center, real‐world study of 67 cases

Niu

Zhang

et al. 2023

Cancer Medicine

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“…DCBM is a condition in which diffuse bone marrow invasion of cancer cells results in leucoerythroblastic anemia, thrombocytopenia, leukopenia, and DIC. DCBM is rare and is usually associated with gastric, breast, lung, and PCa 1 . DCBM in PCa is not mentioned in any of the EAU, NCCN, or Japanese guidelines.…”

Section: Introductionmentioning

confidence: 99%

Two cases of prostate cancer with disseminated carcinomatosis of the bone marrow treated with novel hormonal agents

et al. 2023

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IntroductionDisseminated carcinomatosis of the bone marrow in prostate cancer is rare and has a poor prognosis. Although strong evidence suggests that novel hormonal agents improve the prognosis of metastatic prostate cancer, their effectiveness in cases of disseminated carcinomatosis of the bone marrow remains unclear.Case presentationWe encountered two cases of prostate cancer with disseminated carcinomatosis of the bone marrow at the time of initial diagnosis. One patient was treated with enzalutamide, abiraterone, docetaxel, cabazitaxel, denosumab, and radium‐223 and died 38 months after the initial diagnosis. The other patient was treated with apalutamide and denosumab, and had progression‐free survival for 17 months after the initial diagnosis.ConclusionThese results suggest that novel hormonal agents may improve the prognosis of prostate cancer even in patients with disseminated carcinomatosis of the bone marrow.

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Metronomic cyclophosphamide for bone marrow carcinomatosis in metastatic castration-resistant prostate cancer

Peres,

Aeppli,

Fischer

et al. 2024

J Cancer Res Clin Oncol

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Purpose In some patients with prostate cancer, bone marrow carcinomatosis develops later in the course of the disease, which has a poor prognosis. These are often heavily pretreated patients in the castration-resistant situation for whom there are no other therapeutic options, because either all available systemic therapies have already been used or the use of one is not possible due to the cytopenias associated with bone marrow carcinomatosis. In our literature search, there are no data on this treatment in the setting available, especially no clinical trial or even randomized data. This case series is to determine the clinical efficacy of metronomic cyclophosphamide in patients with metastatic castration-resistant prostate cancer and bone marrow carcinomatosis, particularly with regard to stabilization of the blood count (thrombocytopenias) and thus the possibility of further (more toxic) lines of therapy. Methods Retrospective unicenter analysis was performed on eleven patients between 54 and 84 years of age on metronomic cyclophosphamide for bone marrow carcinomatosis in metastatic castration-resistant prostate cancer treated at a Swiss cancer center between 2014 and 2023. Results Eleven patients received metronomic cyclophosphamide for varying periods of time; the majority had severe cytopenias (especially thrombocytopenias). Partially hematologic stabilization was achieved with administration of further systemic therapies. Conclusion Our case series demonstrates that the use of metronomic cyclophosphamide allows hematologic stabilization for months, benefiting patients who had already received all available therapies for metastatic castration-resistant prostate cancer. Alternatively, it may act as bridging therapy to allow consecutive administration of more toxic therapies with proven survival benefit.

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Bone Marrow Metastases from Solid Organ Cancer in Adults

Cited by 5 publications

References 11 publications

Clinicopathological features and prognosis of breast cancer combined with symptomatic bone marrow metastases: A 10‐year, single‐center, real‐world study of 67 cases

Clinicopathological features and prognosis of breast cancer combined with symptomatic bone marrow metastases: A 10‐year, single‐center, real‐world study of 67 cases

Two cases of prostate cancer with disseminated carcinomatosis of the bone marrow treated with novel hormonal agents

Metronomic cyclophosphamide for bone marrow carcinomatosis in metastatic castration-resistant prostate cancer

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