Importance of bone marrow biopsy in the clinical staging of hodgkin's disease

Webb, Dale I.; Ubogy, George; Silver, Richard T.

doi:10.1002/1097-0142(197008)26:2<313::aid-cncr2820260211>3.0.co;2-r

Cited by 54 publications

(12 citation statements)

References 3 publications

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“…Since only 10 patients were found in the 9 years prior to 1969 at the University of Minnesota Hospitals, it is 23 Furthermore, because of the patchy distribution in the bone marrow, bilateral posterior iliac spine trephine biopsies will be more successful in establishing the presence of marrow involvement than single biopsy. There is no increased morbidity from the bilateral procedure.…”

Section: Discussionmentioning

confidence: 99%

“…7. 23 A review of the records of patients with HL) in the marrow was undertaken to delineate clinical factors common to these patients that would aid in predicting the presence of marrow involvement and to ascertain the response to treatment and the duration of survival. A comparison was made of the clinical characteristics between patients who had bone marrow involvement at the onset of the disease and those who developed i t later.…”

Section: P Usually Have Widely Disseminated Diseasementioning

confidence: 99%

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Hodgkin's disease in the bone marrow

Weiss

Brunning

Kennedy

1975

Cancer

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Tumor involvement of the bone marrow in patients with Hodgkin's disease may be suspected in the presence of other manifestations of advanced disease such as fever, lymphopenia, hypoalbuminemia, mixed cellular histologic type, or Stage III or IV disease by other clinical parameters. It occurs more frequently in the older age groups. When anemia, leucopenia, and/or thrombocytopenia are present and are unrelated to recent bone marrow suppressant chemotherapy, marrow involvement is likely to be present. Bone marrow examination, done by multiple trephine biopsies, provides an adequate sampling of tissue and results in a high incidence of detection of involvement by Hodgkin's disease. This manifestation of Hodgkin's disease is associated with a relatively short survival. Aggressive combination chemotherapy is necessary to produce a significant remission.

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Section: Discussionmentioning

confidence: 99%

Section: P Usually Have Widely Disseminated Diseasementioning

confidence: 99%

Hodgkin's disease in the bone marrow

Weiss

Brunning

Kennedy

1975

Cancer

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“…As far as prognosis is concerned, it is noteworthy that survival was not negatively affected by bone marrow invasion as diagnosed by BMB. Considering only pa- No. 5 BONE MARROW BIOPSY IN BREAST CANCER -Ceci et al 1045 tients with bone involvement it seems to be even longer in BMB positive patients.…”

Section: Discussionmentioning

confidence: 99%

The value of bone marrow biopsy in breast cancer at the time of first relapse.A prospective study

Ceci

Franciosi

Passalacqua

et al. 1988

Cancer

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The value of bone marrow biopsy (BMB) in advanced breast cancer at the time of first relapse was studied in a prospective manner. Bone marrow biopsy was performed in 142 consecutive unselected metastatic patients: 129 at the time of first recurrence, and 13 in patients with metastases at the time of first diagnosis. Overall, BMB was positive in 32 patients (23%). In the group with negative bone x-ray, it was positive in two patients of 84 (2%); both of them had doubtful scan. In the group with positive x-ray, BMB resulted positive in 30 of 58 (52%). There was a significant correlation between number of bone segments radiologically involved and BMB positivity rate, ranging from 15% in the patients with only one, to 68% in those with more than three sites involved (P = 0.02). Patients with x-ray evidence of metastases in the pelvis had significantly higher rate of BMB positivity (67% versus 32%; P = 0.02).The median survival time from the first relapse was 153 weeks in BMB-negative cases and 149 in positive ones. Considering only the patients with demonstration of bone invasion obtained with either or both x-ray and BMB, 34/62 patients had positive BMB (55%). In these cases BMB was found more often positive in patients 50 years or younger than in patients older than 50 years (80% versus 47%; P = 0.05); the median survival time was longer, but not significantly, in BMB-positive patients than in negative ones (149 weeks versus 119; P = 0.3). The authors conclude that BMB is not required in common restaging procedure when both bone survey and scan are negative. Bone marrow biopsy results are more often positive in younger patients and survival is not negatively affected by bone marrow invasion as diagnosed by BMB.Cuncer 61:1041-1045,1988.HE CHOICE OF a proper therapeutic approach of T breast carcinoma is based on an accurate staging procedure, both at time of initial diagnosis and at time of first relapse. The presence or absence of distant metastases is the main prognostic factor, as advanced disease, currently has no chance of cure.The skeleton is a very frequent site of metastatic spread with a reported figure of 50% at the time of first relapse and of 50% to 70% at autopsy.'S2 Bone marrow too, is one of the most frequent disease sites. To some authors, skeletal metastases are always preceded by bone marrow inva~ion.~ Bone marrow biopsy (BMB) already is routinely used.From the

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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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Importance of bone marrow biopsy in the clinical staging of hodgkin's disease

Cited by 54 publications

References 3 publications

Hodgkin's disease in the bone marrow

Hodgkin's disease in the bone marrow

The value of bone marrow biopsy in breast cancer at the time of first relapse.A prospective study

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

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