Bone Marrow Involvement in Non-Hodgkin Lymphoma at Diagnosis

Abstract

Background: In lymphoma, bone marrow infiltration of lymphocytes is a vital information of staging can be done primarily by observer dependent bone marrow study or trephine biopsy. Objective: Aim of this study is to observe the frequency of bone marrow involvement in Non-Hodgkin lymphoma at the time of diagnosis by trephine biopsy and to determine importance of bone marrow trephine biopsy over bone marrow aspiration for staging of Non-Hodgkin lymphoma. Methodology: This was a prospective observational study conducted between January 2014 to July 2014 in department of Haematology, Bangabandhu Shaikh Mujib Medical University (BSMMU) including 30 newly diagnosed patients of Non-Hodgkin’s Lymphoma (NHL) between 15 to 75 years of both sex in non-probability purposive sampling manner confirmed by histopathology of biopsy of lymph node or extra nodal mass. Any secondary disease associated NHL and if there were history of prior chemotherapy was excluded from this study. Detailed clinical history, physical examinations & relevant investigations were recorded in data sheet. After taking written informed consent, these patient’s bone marrow by aspiration and trephine biopsy and peripheral blood sample were sent for study. Results: Comparing bone marrow aspirates (BMA) with bone marrow biopsy (BMB) report revealed that 17 cases were BMB positive among them 12 (70.5%) cases were BMA positive and 5 (29.5%) cases were BMA negative. 13 cases were BMB negative among them 1 (7.7%) case was BMA positive and 12 (92.3%) cases were BMA negative. Statistical analysis revealed significant value (<0.001) that is, there is significant difference observed between two methods to see bone marrow lymphoid infiltration. But in agreement between these two methods we found Kappa (k) value 0.61 indicates a Good agreement between these two tests; that is, we can perform any of these tests to see bone marrow lymphocytes infiltration. Conclusion: Bone marrow study and trephine biopsy can be employed to see lymphoid infiltration in lymphomas with a good agreement; though trephine biopsy has its superiority.