Hodgkin's disease in the bone marrow

Weiss, Raymond B.; Brunning, Richard D.; Kennedy, B. J.

doi:10.1002/cncr.2820360924

Cited by 17 publications

(7 citation statements)

References 16 publications

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“…We were able to confirm that several of these factors were significant (Table 11). In particular, constitutional symptoms have been reported in 78-100% of Hodgkin's patients with marrow invasion [9,[11][12][13][14]. Similarly, we noted B symptoms in 88% of patients with a positive bone marrow biopsy compared to 32% without (P = .OOl).…”

Section: Disc Ussl Onsupporting

confidence: 69%

“…We also detected significant differences in pretreatment values of hemoglobin, leukocytes, and platelets in patients with a positive marrow biopsy. While some investigators noted similar findings [ 11,13,20,21], others have not [10,18,19]. It is noteworthy, however, that isolated cytopenias unrelated to marrow metastasis are not uncommon in Hodgkin's disease and may be secondary to diverse mechanisms, including hypersplenism and immune phenomena.…”

Section: Disc Ussl Onmentioning

confidence: 98%

“…Several clinical characteristics have been reported to be associated with bone marrow involvement. These include male sex, older age, the presence of B symptoms, cytopenias, mixed cellularity or lymphocyte depletion, histologic type, advanced stage disease, and elevated alkaline phosphatase [9,[11][12][13][14]16,. We were able to confirm that several of these factors were significant (Table 11).…”

Section: Disc Ussl Onmentioning

confidence: 99%

“…Both male sex and older age have also been reported in the majority of patients with Hodgkin's disease in the marrow [9,11,13,21]. In the Stanford series [9], twothirds of the patients with this manifestation were male with a median age of 48 years.…”

Section: Disc Ussl Onmentioning

confidence: 99%

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Bone marrow biopsy in the initial staging of Hodgkin's disease

Doll

Ringenberg

Anderson

et al. 1989

Med. Pediatr. Oncol.

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Results of bone marrow biopsy were retrospectively evaluated in 120 previously untreated patients with Hodgkin's disease. The incidence of bone marrow involvement was 13%. All patients with marrow invasion had B symptoms and/or clinically advanced disease. When patients with bone marrow involvement were compared to those without there were significant differences in the incidence of B symptoms, the clinical stage, hemoglobin levels, leukocyte counts, platelet counts, and serum levels of lactate dehydrogenase and alkaline phosphatase. None of 59 patients with clinical stage IA and IIA had evidence of marrow invasion. This study demonstrates that trephine bone marrow biopsy is of value in detecting marrow involvement in specific subgroups of untreated patients with Hodgkin's disease, i.e., those patients with constitutional symptoms and/or clinical stage III or IV. However, bone marrow biopsy adds little to the initial staging of patients with clinical stage IA and IIA. Routine use of this procedure in such patients may be unnecessary.

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Section: Disc Ussl Onsupporting

confidence: 69%

Section: Disc Ussl Onmentioning

confidence: 98%

Section: Disc Ussl Onmentioning

confidence: 99%

Section: Disc Ussl Onmentioning

confidence: 99%

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Bone marrow biopsy in the initial staging of Hodgkin's disease

Doll

Ringenberg

Anderson

et al. 1989

Med. Pediatr. Oncol.

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“…In Hodgkin's disease (HD) bone marrow trephine biopsies are usually performed to exclude or to document marrow involvement. Positive marrow biopsies are reported to occur in between 2 and 29% of the untreated patients (Bartl, Burkhardt, Lengsfeld & Huhn 1976), the variation being due to differences not only in patient populations and selection but also in biopsy and histological techniques (Bartl et al 1976, Weiss, Brunning & Kennedy 1975 and in the interpretation of histological foci with and without Reed Sternberg cells (Bartl et al 1976, O'Carrol, McKenna & Brunning 1976, Meyers, Chabner, de Vita & Gralnick 1974, Webb, Ubogy & Silver 1970. The reports generally concentrate on the diagnostic lesions, and the 'non-involved' marrow is often stated to be normal.…”

Section: Introductionmentioning

confidence: 99%

The bone marrow in Hodgkin's disease: the non‐involved marrow

Velde¹,

Ottolander²,

Spaander³

et al. 1978

Histopathology

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One hundred and nineteen methacrylate-embedded trephine biopsy specimens from 80 patients with Hodgkin's disease are reviewed. Although marrow involvement was found in 4% of the untreated patients, the present study was mainly concerned with the marrow unaffected by specific infiltrates and in negative specimens. The non-involved bone marrow in Hodgkin's disease invariably showed alterations of three types; stromal damage, inflammatory infiltration, and disturbed haematopoiesis. Each of these features can be found in the absence of one or both of the others. In severe examples, all three of these components usually occur simultaneously, giving histological pictures that mimic Hodgkin-specific infiltrates, sometimes in association with clinical suggestions of bone marrow involvement or replacement. But trephine biopsies of sufficiently high histological quality offer alternative explanations for the pancytopenia, for instance intramedullary phagocytosis, reactive sclerosing inflammation resembling auto-immune disorders, or a disturbance of haematopoiesis itself. This disturbance could be due to a defect inherent in the haematopoiesis associated with Hodgkin's disease, possibly predisposing for leukaemia in longterm survivors who have received chemotherapy and/or irradiation. The disturbed erythropoiesis proved to be strongly correlated with the stage of the disease at the time of biopsy. This finding could contribute to staging procedures, when laparotomy is contraindicated.

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Hodgkin's disease: Problems of staging

Sweet

Kinnealey

Ultmann

1978

Cancer

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The preferred histopathological classification of Hodgkin's disease (HD) is that suggested by Lukes and Butler as modified at the Rye Symposium; the histologic subtypes are highly reproducible and correlate well with the anatomic sites of involvement, clinical stage, and survival. The accuracy of the bipedal lymphangiogram, 67gallium scan, and ultrasonography in predicting abdominal involvement by HD is 90% , 50%, and 88%, respectively. Staging laparotomy remains the most accurate method of detecting intra-abdominal disease and has added immensely to new concepts in the management of HD. These concepts suggest that patients with nodal disease limited to the celiac axis or upper para-aortic areas (substage III1) or pathologic stage (PS) IIIS+N-A, when treated with extended field radiotherapy alone have survival rates comparable to PS IIA patients. In contrast, patients in PS IIIA with lower abdominal nodal disease (substage III2), regardless of splenic involvement, have a prognosis comparable to PS IV disease. Thus, there may only be two stages of HD, those curable with extended mantle or smaller radiotherapy fields alone, and those requiring chemotherapy with or without supplemental radiotherapy.

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Hodgkin's disease in the bone marrow

Cited by 17 publications

References 16 publications

Bone marrow biopsy in the initial staging of Hodgkin's disease

Bone marrow biopsy in the initial staging of Hodgkin's disease

The bone marrow in Hodgkin's disease: the non‐involved marrow

Hodgkin's disease: Problems of staging

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