Bilateral Trephine Bone Marrow Biopsies in Lymphoma and Other Neoplastic Diseases

Brunning, Richard D.; Bloomfield, Clara D.; McKenna, Robert W.; Peterson, LoAnn

doi:10.7326/0003-4819-82-3-365

Cited by 232 publications

(111 citation statements)

References 7 publications

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“…2). This phenomenon was demonstrated in studies of bilateral biopsies in which positive findings were present only unilaterally in 10-40% of patients with marrow involvement by lymphoma and other diseases [11,12]. MR imaging can be used to more fully assess marrow involvement in lymphoma, and to specifically identify appropriate potential biopsy sites.…”

Section: Lymphoproliferative Diseasesmentioning

confidence: 96%

Magnetic resonance imaging of bone marrow in oncology, Part 2

Hwang

Panicek

2007

Skeletal Radiol

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Magnetic resonance imaging plays an integral role in the detection and characterization of marrow lesions, planning for biopsy or surgery, and post-treatment followup. To evaluate findings in bone marrow on MR imaging, it is essential to understand the normal composition and distribution of bone marrow and the changes in marrow that occur with age, as well as the basis for the MR signals from marrow and the factors that affect those signals; these points have been reviewed and illustrated in part 1 of this two-part article. Part 2 will emphasize the practical application of MR imaging to facilitate differentiation of normal marrow, tumor, and treatment-related marrow changes in oncology patients, and will review complementary MR techniques under development.

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Section: Lymphoproliferative Diseasesmentioning

confidence: 96%

Magnetic resonance imaging of bone marrow in oncology, Part 2

Hwang

Panicek

2007

Skeletal Radiol

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“…22 However, there is no proof that aggressive therapy, even including high-dose chemotherapy in conjunction with autologous bone marrow or stem cell transplantation, can improve survival or produce cure. [5][6][7][8]11,12,23 Additionally, the high incidence of bone marrow involvement in SCCL 24,25 limits the effectiveness of autologous transplantation. Accordingly, the use of purged autologous marrow has been advocated 9,26 as has the use of allogeneic marrow.…”

Section: Discussionmentioning

confidence: 99%

High-dose therapy with autologous or allogeneic transplantation as salvage therapy for small cleaved cell lymphoma of follicular center cell origin

Stein

Greer

Goodman

et al. 1999

Bone Marrow Transplant

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Summary:Between 1985 and 1996, 51 patients with relapsed or refractory small cleaved cell lymphoma (SCCL) received high-dose chemotherapy ؎ TBI in conjunction with autologous (ABMT) (36 patients) or allogeneic transplantation (15 patients). Patients were eligible for ABMT if the bone marrow biopsy done prior to the planned transplant did not reveal microscopic involvement with SCCL. Patients receiving ABMT had a median age of 48 years, had received a median of 2.5 chemotherapy regimens prior to transplantation, and were transplanted a median of 35.5 months from diagnosis. Among patients receiving ABMT, 5 year actuarial survival was 56 ؎ 11%. Median survival was 126؉ months, and median survival from diagnosis was 191 months. Univariate and multivariate analysis identified sensitive disease as the best predictor of a favorable response. Five-year actuarial survival was 66 ؎ 12% for patients with sensitive disease at the time of transplant as compared to 29 ؎ 17% for patients with resistant disease, P = 0.015. Median survival in patients with sensitive disease at the time of ABMT was 126؉ months. By univariate analysis, survival was significantly better for patients receiving ABMT as compared to patients receiving allogeneic transplants. Median survival following allogeneic transplantation was 5 months; 5 year actuarial survival was 15 ؎ 13%. In a multivariate analysis, which considered autologous vs allogeneic transplantation, sensitive vs resistant disease, Ͻ3 vs у3 prior treatments, and prior bone marrow involvement, allogeneic transplantation was significantly associated with poor survival. Treatment-related mortality occurred in eight of 15 patients receiving allogeneic transplantation and limited the effectiveness of this therapy. High-dose therapy in conjunction with ABMT is effective therapy for patients with SCCL whose disease is sensitive to chemotherapy and whose marrows are microscopically free of disease. Because of possible selection bias, it has not been proven that this approach increases survival in these patients. Treatment-related

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“…Focal bone marrow involvement is typical in HL. It may be missed even if a bilateral bone marrow biopsy is taken in the dorsal iliac crest (sampling error) (Brunning et al, 1975).…”

mentioning

confidence: 99%