Role of bone marrow examination in staging Hodgkin's disease: experience in México

Gómez‐Almaguer, David; Gj, Ruiz-Argüelles; López-Martı́nez, Briceida; Estrada, Erick; Lobato-Mendizábal, E; Jc, Jaime-Pérez

doi:10.1046/j.1365-2257.2002.00450.x

Cited by 8 publications

(4 citation statements)

References 12 publications

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“…although BM involvement has been reported to be less common in Hl when compared to non-Hodgkin lymphomas (4), it is still essential to do BM staging in Hl as it has prognostic significance (5). The incidence of BM involvement in Hl in our study is consistent with the literature, which indicates a range between 3-18 % in many studies (4)(5)(6)(7)(8).…”

Section: Discussionsupporting

confidence: 82%

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Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Sudalaimuthu

Basu²

2017

TJPATH

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Objective: the frequency of bone marrow infiltration by Hodgkin lymphoma is low and varies from 3 to 18%. Hence there exists a dilemma whether bone marrow staging should be done only in the high risk cases. this study aims to study the clinicopathological features and the histomorphology of bone marrow infiltration by Hodgkin lymphoma. Material and Method:Bone marrow aspirates and biopsies from cases of Hodgkin lymphoma diagnosed between 2007 and 2015 were studied. immunohistochemistry with CD15 and CD30 were done in necessary cases. Bone marrow infiltration was correlated with various clinicopathological parameters.Results: ten of the 81 cases (12.3%) studied showed infiltration by Hodgkin lymphoma in the bone marrow biopsy sections. all the aspirates were negative. Bone marrow in the involved cases showed Reed-Sternberg cells and/or mononuclear Hodgkin cells positive for CD30 in a polymorphous inflammatory background. Cases of lymphocyte depleted subtype (66%) and those with leucopenia/ thrombocytopenia (100%) were frequently associated with bone marrow infiltration. B-symptoms, anemia and mixed cellularity were the other risk factors. However none of these risk factors were noted in two out of the ten cases with bone marrow infiltration.Conclusion: as the role of bone marrow aspirate is minimal in the staging of Hodgkin lymphoma, bone marrow biopsy should be the method of choice. immunohistochemistry helps in the doubtful cases. Bone marrow involvement was frequent but not confined to the high risk groups. Our findings suggest that bone marrow staging should not be restricted to the high risk cases alone.

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Section: Discussionsupporting

confidence: 82%

“…Studies have shown that the frequency of BM involvement in Hl is low and varies from 4 to 18% (4)(5)(6)(7). Hence some authors have suggested that BM studies can be done in selected high risk cases alone (5,8,9). However, a controversy exists as few other authors suggest that BM should be done in all the adult cases (1,10).…”

mentioning

confidence: 99%

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Sudalaimuthu

Basu²

2017

TJPATH

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“…Patients without these clinical factors are unlike to have BM infiltration. Some authors raise the question about the opportunity to perform the BMB in the absence of these features (12). The predictive value of the absence of fever in regard to the absence of BM infiltration is 98% (13).…”

Section: Clinical and Laboratory Datamentioning

confidence: 99%

Bone marrow biopsy in Hodgkin's lymphoma

Franco

Tripodo

Rizzo

et al. 2004

European J of Haematology

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: In the study of patients with Hodgkin's lymphoma (HL) the evaluation of bone marrow biopsy (BMB) can be difficult. In this review we analyze the main diagnostic features and the clinical risk factors of BM involvement. Although the role of BMB is criticized by some authors, its value is irreplaceable in the staging of HL and in the diagnosis of primary medullary HL. The Ann Arbor staging committee criteria should be revised and updated in the light of the current immunohistochemical studies that give a fundamental help in the diagnostic process. A single BMB should be adequate for diagnosis in most instances. In cases of suspicious involvement a controlateral BMB could be performed.

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“…In this respect, it has previously been shown that only about 2% of patients in this population with HL have a positive BM biopsy. 13 …”

Section: Methodsmentioning

confidence: 99%

High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center

Jaime‐Pérez

Gamboa-Alonso

Padilla-Medina

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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BackgroundReports dealing with clinical outcomes of classical Hodgkin's lymphoma in low- to middle-income countries are scarce and response to therapy is poorly documented. This report describes the characteristics and clinical outcomes of patients with classical Hodgkin's lymphoma from a single institution in Latin America.MethodA retrospective study was conducted over ten years of patients with classical Hodgkin's lymphoma treated at a referral center. Progression-free and overall survival rates were estimated by Kaplan–Meier analysis. The univariate Cox regression model was used to estimate associations between important variables and clinical outcomes.Main resultsOne hundred and twenty-eight patients were analyzed. The mean age was 28.5 years. The five-year progression-free and overall survival were 37.3% and 78.9%, respectively. Of the whole group, 55 (43%) were primary refractory cases. Only 39/83 (47%) patients with advanced disease vs. 34/45 (75.6%) in early stages (p-value = 0.002) achieved complete remission. Those with advanced disease had a five-year overall survival of 68.7% vs. 91.8% for early disease (p-value = 0.132). Thirty-one patients relapsed (24.2%) and 20 (64.5%) received a transplant. The hazard ratio for progression with bone marrow infiltration was 2.628 (p-value = 0.037). For death, an International Prognostic Score ≥4 had a hazard ratio of 3.355 (p-value = 0.050) in univariate analysis. Two-thirds of classical Hodgkin's lymphoma patients diagnosed at advanced stages had a low progression-free survival but an overall survival similar to high-income countries.ConclusionPatients diagnosed with classical Hodgkin's lymphoma in Northeastern Mexico had a significantly low progression-free survival rate and presented with advanced disease, underscoring the need for earlier diagnosis and improved contemporary therapeutic strategies in these mainly young productive-age Hodgkin's lymphoma patients.

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Role of bone marrow examination in staging Hodgkin's disease: experience in México

Cited by 8 publications

References 12 publications

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Clinicopathological features of bone marrow infiltration in hodgkin lymphoma. should bone marrow staging be done only in high risk patients?

Bone marrow biopsy in Hodgkin's lymphoma

High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center

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