Bone marrow metastases in small cell lung cancer: detection with magnetic resonance imaging and monoclonal antibodies

Immunocytochemical assessment of bone marrow aspirates for monitoring response to chemotherapy in small-cell lung cancer patients

“…This finding confirms immunocytochemistry as a more sensitive procedure in assessing BM for malignant cells in SCLC patients. In fact, also previous studies reported that 30-50% of LD patients had BMA contamination when evaluated immunocytochemically (Berendsen et al, 1988;Hay et al, 1988;Moss et al, 1988;Trillet et al, 1989;Beiske et al, 1992;Pasini et al, 1994bPasini et al, , 1995Pasini et al, , 1998. The amount of marrow involvement of these 'untrue LD' patients was apparently lower than that of ED patients, though this did not achieve statistical significance.…”

“…Moreover, most staging protocols include BM assessment through morphological screening of mono-or bilateral core biopsies, aspiration clots or smears from iliac crests (Abrams et al, 1998). Many studies have addressed the detection of SCLC cells in bone marrow aspirates (BMA) by immunocytochemistry (Frew et al, 1986;Berendsen et al, 1988;Hay et al, 1988;Moss et al, 1988;Trillet et al, 1989;Leonard et al, 1990;Beiske et al, 1992;Skov et al, 1992;Myklebust et al, 1993aMyklebust et al, , 1993b, but the clinical relevance of this approach is still debated. Furthermore, few reports have investigated the relationship between BM involvement and prognosis (Leonard et al, 1990;Bucher et al, 1994;Pasini et al, 1994bPasini et al, , 1995Pasini et al, , 1998, but no study has systematically assessed the effects of treatment on marrow contamination in sequential BMA.…”

“…A growing body of evidence suggests that not only BM contamination by SCLC cells is far more frequent than previously shown by traditional cytohistological methods (Stahel et al, 1985;Leonard et al, 1990;Pasini et al, 1994bPasini et al, , 1995 but also that BM involvement may have clinical relevance (Leonard et al, 1990;Bucher et al, 1994;Pasini et al, 1994bPasini et al, , 1995. Immunocytochemistry is a convenient method for detecting BM micrometastases thanks to its simplicity, reliability and relative low cost (Leonard et al, 1990;Molino et al, 1991;Beiske et al, 1992;Skov et al, 1992;Pasini et al, 1994a), whereas other techniques, such as in vitro cultures of marrow cells (Pollard et al, 1981;Hunter et al, 1987;Everard et al, 1990) or magnetic resonance imaging (Trillet et al, 1989), are cumbersome, time-consuming and expensive.…”

Effective removal of SCLC cells from human bone marrow. Use of four monoclonal antibodies and immunomagnetic beads

“…High dose chemotherapy followed by ABMT in SCLC patients has been used by several investigators (Humblet et al, 1987;Symann et al, 1989;Souhami et al, 1989;Williams et al, 1989;Marangolo et al, 1989;Nomura et al, 1990;Lazarus et al, 1990;Gomm et al, 1991) Berendsen et al, 1988;Canon et al, 1988;Trillet et al, 1989;Beiske et al, 1992). It should also be noted that the detection of tumour cells in bone marrow is based on studies of small volume aspirates, whereas about 11 of bone marrow is harvested for ABMT.…”

“…One contributing factor may be infiltration of tumour cells in the transfused bone marrow. It has become increasingly clear that tumour cells are often present in the marrow of SCLC patients, even if cytomorphological and histomorphological analysis remains negative Berendsen et al, 1988;Canon et al, 1988;Trillet et al, 1989;Beiske et al, 1992). In order to prevent giving tumour cells back to the patient, it is logical to purge the bone marrow for tumour cells before reinfusion.…”