Bone Marrow Involvement in Neuroblastoma: A Study of Hemato-morphological Features

Abstract

Bone marrow involvement in neuroblastoma indicates advanced stage of disease. The recent use of autologous bone marrow ''rescue'', has provided an additional important reason for accurate assessment of bone marrow status in newly diagnosed patients. In this study, we analyzed 44 cases of neuroblastoma for bone marrow infiltration status and their hematological parameters. Eighty-eight bone marrow aspirate and trephine touch imprint smears and 44 trephine biopsy sections were examined in these 44 patients. Of these, 24 cases (54.5 %) showed marrow infiltration. Leucopenia and bicytopenia were significantly (p \ 0.05) associated with marrow infiltration. Both bone marrow aspirate and biopsy were positive for infiltration in 16 out of 24 positive cases. Only aspirate smears were positive in 4 and only trephine biopsy in another 4 cases. The pattern of infiltration consisted of rosette formation in 40.7 % cases on aspirate smears and 22.2 % cases in trephine biopsies. Remaining cases showed diffuse and interstitial presence of tumor cells and cases positive only on trephine biopsy, showed marked stromal reaction. Bilateral trephine biopsies combined with aspirate smears picked up all positive cases compared to when they were assessed alone.

Study of Hemato-morphological Features in Neuroblastoma Infiltrating Marrow

“…17 In this study, 44 patients (55.6%) showed bone marrow infiltration by neuroblastoma. Pulkit et al 18 found similar findings and noted marrow In our study, thrombocytopenia and the presence of nucleated red blood cells (nRBCs) in patients with and without marrow invasion showed a statistically significant difference. Bone marrow involvement causes inhibition of normal hematopoiesis, which results in peripheral cytopenias.…”

“…17 In this study, 44 patients (55.6%) showed bone marrow infiltration by neuroblastoma. Pulkit et al 18 found similar findings and noted marrow involvement in 54.5% of cases under the age of 5 years, with male predominance. Cozzutto et al 19 In our study, thrombocytopenia and the presence of nucleated red blood cells (nRBCs) in patients with and without marrow invasion showed a statistically significant difference.…”

“…17 In this study, 44 patients (55.6%) showed bone marrow infiltration by neuroblastoma. Pulkit et al 18 found similar findings and noted marrow involvement in 54.5% of cases under the age of 5 years, with male predominance. Cozzutto et al 19 also observed similar findings in 58.3% of cases (7 out of 12 cases), and Franklin et al 20 reported a similar frequency in 48.9% of cases (24 out of 49 cases).…”

Regulation of neuroblastoma migration, invasion, and in vivo metastasis by genetic and pharmacological manipulation of MDA-9/Syntenin

“…S3). NB metastasis to bone marrow is an important prognostic factor and examining homing of cancer cells to the bone marrow is relevant [25]. Human bone marrow stromal cells (HS-5) and NB cells separated by a 500 μM space were placed on opposite sides of trans-well inserts.…”

Long Non-Coding RNAs in Neuroblastoma: Pathogenesis, Biomarkers and Therapeutic Targets

“…For localized tumors, bilateral lymph-node biopsy is recommended [9]. Given the prevalence of bone marrow involvement, bone marrow aspiration and trephine biopsy are also recommended [10]. Although primary tumor detection is important, the diagnosis of neuroblastoma can also be based on the histological positivity of a bone marrow biopsy or aspirate sample.…”