Occult bone marrow involvement in patients with diffuse large B-cell lymphoma: results of a pilot study

Talaulikar, Dipti; Dahlstrom, Jane E.; Shadbolt, Bruce; McNiven, Michelle; Broomfield, Amy; Pidcock, Michael

doi:10.1080/00313020701684417

Cited by 19 publications

(20 citation statements)

References 27 publications

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“…38 In a pilot study on 36 patients with DLBCL, we found four BM-/IHCþ cases (11.1%). 21 Similar results were noted on a larger study of 156 patients, with BM involvement on routine histology in 30 (19.2%) cases and an 11.1% (17 cases) rate of occult involvement using IHC. 23 Hanson et al have previously reported no benefit from flow cytometry or immunohistochemistry to routine histological diagnosis in all subtypes of NHL.…”

Section: Immunohistochemical Analysissupporting

confidence: 87%

“…Previous studies showed that histological involvement did not significantly affect overall survival. 21 However, a recent larger study (n ¼ 156) detected BM involvement histologically in 30 cases (19%) and demonstrated, in keeping with the findings of other groups, that BM involvement had a negative impact on overall survival. 23 We believe the discrepancy between these studies is related to histological characteristics, with a greater representation of discordant involvement in the earlier series.…”

Section: Histological Examination Of the Bone Marrowmentioning

confidence: 50%

“…14 The studies that have addressed the impact of histological BM involvement on outcome measures such as survival and progression-free survival in aggressive B-cell NHL have varied in their results depending on the study design and population. 11,13,[21][22][23] The most important predictors appear to be the degree of infiltration, pattern of infiltration and the presence of large (concordant involvement) or small cells (discordant involvement) in the BM 11,13 (Table 1). Yan et al studied 60 adult patients with aggressive B-cell NHL and BM involvement at initial presentation.…”

Section: Histological Examination Of the Bone Marrowmentioning

confidence: 98%

“…67 In a pilot study, we have reported rates similar to the study by Mitterbauer-Hohendanner et al 61 (performed on aspirate samples), with six of 36 cases (16.6%) showing clonality on IgH FRI and FRIII analysis on formalin-fixed decalcified paraffin-embedded (FFDPE) trephine tissue. 21 We were able to use a summative model to define bone marrow involvement (positive histology, flow cytometry, IHC and/ or IgH studies) and to better predict prognosis in these patients. However, a larger study performed on 156 FFDPE trephine biopsies has failed to demonstrate that molecular staging with IgH/IgL affects prognosis (unpublished observations).…”

Section: Molecular Studies In Dlbclmentioning

confidence: 99%

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Staging bone marrow in diffuse large B-cell lymphoma: the role of ancillary investigations

Talaulikar

Dahlstrom

2009

Pathology

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Section: Immunohistochemical Analysissupporting

confidence: 87%

Section: Histological Examination Of the Bone Marrowmentioning

confidence: 50%

Section: Histological Examination Of the Bone Marrowmentioning

confidence: 98%

Section: Molecular Studies In Dlbclmentioning

confidence: 99%

See 2 more Smart Citations

Staging bone marrow in diffuse large B-cell lymphoma: the role of ancillary investigations

Talaulikar

Dahlstrom

2009

Pathology

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“…Dissemination to bone marrow (BM) occurs in advanced clinical stages and varies in different series from 11% to 35% [1,2]. Minimal infiltration can be detected if auxiliary studies are conducted together with the morphological evaluation, using immunohistochemistry markers or polymerase chain reaction (PCR) in the bone marrow (BM) specimen biopsy [8]. The prevalence of discordant infiltration varies in different reports and ranges from rare to 70% [9,10].…”

Section: Introductionmentioning

confidence: 99%

Association of Morphology and Immunophenotype in Diffuse Large B-Cell Lymphomas with Bone Marrow Infiltration in a Sample Mexican Population

Romero-Guadarrama¹,

Ponce²,

Cruz³

et al. 2012

OJPathology

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Introduction: Diffuse large B-cell lymphoma (DLBCL), not otherwise specified, is a large B-cell lymphoma with a diffuse growth pattern and aggressive clinical course. It is divided in subgroups according to its morphology, immunophenotype, and primary site. Dissemination to bone marrow occurs in 11% to 35% of cases and can be of concordant or discordant morphology. Objective: To examine the association, the type of bone marrow involvement in relation to the primary site, morphology, immunohistochemistry of DLBCLs and to determine the cases of Epstein-Barr virus positive DLBCLs. Materials and Methods: We reviewed lymph node and extranodal biopsies as well as the respective bone marrow biopsies in all cases of DLBCL diagnosed in the Hospital General de México during the period from 2002 to 2010. We used immunohystochemistry for immunophenotype identification (Hans's algorithm) and an in-situ hybridization technique to detect presence of Epstein Barr encoded RNA (EBER). Results: We included 108 patients with a mean age of 51.9 years, 59 (55%) were men. DLBCL involved lymph nodes in 60% of cases and palatine tonsils in 13%. The centroblastic variant predominated (80%) and 58% originated from activated B-cells. Infiltration of bone marrow was present in 30% of cases and was discordant in 55% of these cases. Correlation between morphology and bone marrow infiltration was statistically significant (P = 0.0003). Presence of Epstein-Barr virus was demonstrated in 15% of patients older than 50 years. Conclusions: Dissemination to bone marrow occurred in 30% of cases and discordant involvement was most common. DLBCL originating from activated B-lymphocytes predominated and the most common extranodal sites were palatine tonsils, suggesting that our population has a clinical behavior similar to Asiatic populations.

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Utility of leukocyte‐associated immunoglobulin‐like receptor‐1 (CD305) in flow cytometric detection of minimal bone marrow involvement by B‐cell non‐Hodgkin lymphoma

Singh,

Patil,

Ghogale

et al. 2024

Cytometry Part B Clinical

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Multicolor flow cytometry (MFC) is crucial in detecting occult or minimal bone marrow (BM) involvement by non‐Hodgkin lymphomas (NHL), which may not be detected using trephine biopsy or imaging studies. Detection of low‐level BM involvement can be challenging without definite immunophenotypic aberrancies. We studied the utility of CD305 in MFC detection of minimal BM involvement by B‐NHL, especially in the absence of aberrancies by commonly used markers. The study included 1084 consecutive BM samples submitted for the staging of B‐NHLs (excluding CLL) over two years. Samples were studied for morphological, immunophenotypic, and histopathological assessment. MFC studies were performed using 10–13 color MFC, including CD305‐antibody (clone, DX26). Minimal BM involvement was defined with a cutoff of ≤10% lymphoma cells in viable cells on MFC assessment. Of 1084, 148 samples revealed overt morphological involvement by B‐NHL and were excluded from analysis. BM samples of 172/936 patients were morphologically negative but revealed involvement using MFC independently. Corresponding trephine biopsy involvement was detected in only 79/172 (45.9%) patients. On MFC, 23/172 samples showed BM involvement with >10% lymphoma cells, and 149/172 (86.6%) samples revealed minimal involvement. In 54/149 (36.24%) samples, lymphoma cells were detected only with aberrant loss of CD305 expression. In 78 of the remaining 95 samples (82.1%), it provided an immunophenotypic aberrancy addition to other markers and supported the results. CD305 is a highly useful marker in the flow cytometric assessment of minimal BM involvement by B‐NHL. MFC is a superior modality to trephine biopsy in detecting low‐level BM involvement.

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Occult bone marrow involvement in patients with diffuse large B-cell lymphoma: results of a pilot study

Cited by 19 publications

References 27 publications

Staging bone marrow in diffuse large B-cell lymphoma: the role of ancillary investigations

Staging bone marrow in diffuse large B-cell lymphoma: the role of ancillary investigations

Association of Morphology and Immunophenotype in Diffuse Large B-Cell Lymphomas with Bone Marrow Infiltration in a Sample Mexican Population

Utility of leukocyte‐associated immunoglobulin‐like receptor‐1 (CD305) in flow cytometric detection of minimal bone marrow involvement by B‐cell non‐Hodgkin lymphoma

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