Utility of repeating bone marrow biopsy for confirmation of complete response in multiple myeloma

Tschautscher, Marcella; Jevremović, Dragan; Buadi, Francis K.; Lacy, Martha Q.; Gertz, Morie A.; Dispenzieri, Angela; Kapoor, Prashant; Dingli, David; Hwa, Lisa; Fonder, Amie; Hobbs, Miriam; Hayman, Suzanne R.; Lust, John A.; Russell, Stephen J.; Leung, Nelson; Go, Ronald S.; Lin, Yi; Gonsalves, Wilson I.; Kourelis, Taxiarchis; Warsame, Rahma; Kyle, Robert A.; Rajkumar, S. Vincent; Kumar, Shaji

doi:10.1038/s41408-020-00363-6

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…Diagnosis of MM by International Myeloma Working Group (IMWG) guidelines demands a BM biopsy in almost all cases [3]. In contrast to the other obligatory procedures, BM biopsy still is a painful and uncomfortable experience for most patients [6,7]. Despite IMWG recommendations, a recent large-scale clinical analysis challenged the obligation of regular invasive BM diagnostic for patients with evidence of monoclonal antibody, since in most cases it did not contribute to the diagnosis [5].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of artificial intelligence–supported assessment of bone marrow infiltration using dual-energy computed tomography in patients with evidence of monoclonal protein — a retrospective observational study

Fervers

Kottlors

et al. 2021

Eur Radiol

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Objectives To demonstrate the feasibility of an automated, non-invasive approach to estimate bone marrow (BM) infiltration of multiple myeloma (MM) by dual-energy computed tomography (DECT) after virtual non-calcium (VNCa) post-processing. Methods Individuals with MM and monoclonal gammopathy of unknown significance (MGUS) with concurrent DECT and BM biopsy between May 2018 and July 2020 were included in this retrospective observational study. Two pathologists and three radiologists reported BM infiltration and presence of osteolytic bone lesions, respectively. Bone mineral density (BMD) was quantified CT-based by a CE-certified software. Automated spine segmentation was implemented by a pre-trained convolutional neural network. The non-fatty portion of BM was defined as voxels > 0 HU in VNCa. For statistical assessment, multivariate regression and receiver operating characteristic (ROC) were conducted. Results Thirty-five patients (mean age 65 ± 12 years; 18 female) were evaluated. The non-fatty portion of BM significantly predicted BM infiltration after adjusting for the covariable BMD (p = 0.007, r = 0.46). A non-fatty portion of BM > 0.93% could anticipate osteolytic lesions and the clinical diagnosis of MM with an area under the ROC curve of 0.70 [0.49–0.90] and 0.71 [0.54–0.89], respectively. Our approach identified MM-patients without osteolytic lesions on conventional CT with a sensitivity and specificity of 0.63 and 0.71, respectively. Conclusions Automated, AI-supported attenuation assessment of the spine in DECT VNCa is feasible to predict BM infiltration in MM. Further, the proposed method might allow for pre-selecting patients with higher pre-test probability of osteolytic bone lesions and support the clinical diagnosis of MM without pathognomonic lesions on conventional CT. Key Points • The retrospective study provides an automated approach for quantification of the non-fatty portion of bone marrow, based on AI-supported spine segmentation and virtual non-calcium dual-energy CT data. • An increasing non-fatty portion of bone marrow is associated with a higher infiltration determined by invasive biopsy after adjusting for bone mineral density as a control variable (p = 0.007, r = 0.46). • The non-fatty portion of bone marrow might support the clinical diagnosis of multiple myeloma when conventional CT images are negative (sensitivity 0.63, specificity 0.71).

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Section: Introductionmentioning

confidence: 99%

Feasibility of artificial intelligence–supported assessment of bone marrow infiltration using dual-energy computed tomography in patients with evidence of monoclonal protein — a retrospective observational study

Fervers

Kottlors

et al. 2021

Eur Radiol

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“…(Figure 3) In the general population, a wide variety of hematological diseases may be found ranging from mild problems such as such as iron deficiency anemia to severe condition, such as bone marrow infiltration [3][4][5]23 . Most hematological illnesses may be definitively diagnosed with a bone marrow aspiration and biopsy, which is one of the most useful diagnostic procedures available 24 . It is a common invasive procedure used in hematology used routinely 25 .…”

Section: Resultsmentioning

confidence: 99%

Frequency of Hematological Malignancies Based on Bone-Marrow Aspiration and Trephine Biopsy in Patients Presenting to Tertiary Care Hospital

Iqbal¹,

Hussain²,

Malik³

et al. 2022

PJMHS

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Background: Hematological disorders are found commonly in the general population existing on both ends of the spectrum with minute disorders like iron deficiency anemia to as severe as bone marrow infiltration Objective: To assess the frequency of hematological malignancies based on bone-marrow aspiration and trephine biopsy in patients presenting to tertiary care hospital Methodology: The current study was cross-section descriptive study carried out at the Pathology department of Bacha Khan Medical College, Mardan from April 2013 to October 2021. Bone-marrow aspiration and trephine biopsy was done for all the patients. Data regarding gender, age, clinical examination and diagnosis was recorded on a proforma designed for this research. Results were analyzed by using IBM SPSS (version 23). Results: In our study, a total of 182 patients were included. The mean age (±SD) in the current study was 41 (12.6) years. Based on the malignant hematological disorder, acute myelogenous leukemia was diagnosed in 15 (23.08%) patients, acute lymphoblastic leukemia in (23.08%) patients, chronic myeloid leukemia in 14 (21.54%) patients, acute leukemias in 3 (4.62%) patients, Myeloproliferative neoplasms in 6 (9.23%) patients, Lymphoproliferative disease in 11 (16.92%) patients while plasma cell myeloma was diagnosed in 1 (1.54%) patients. Conclusion: Our study concludes that acute myelogenous leukemia (AML) and acute lymphoblastic leukemia (ALL) is the most common hematological malignancies in Bacha Khan Medical College followed by chronic myeloid leukemia (CML) which is the second highest malignancies in Bacha Khan Medical College in this specific time. Keywords: hematological malignancies, bone-marrow aspiration, trephine biopsy

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“…Bone marrow aspiration and biopsy is one of the beneficial tools for making the ultimate diagnosis of most of the hematological disorders (7). It is one of the invasive technique performed routinely in hematology (8).…”

Section: Discussionmentioning

confidence: 99%

“…Metastases in bone marrow were observed in seven cases which were from prostate, vertebrae, primary B cell CNS lymphoma, Plasma cell tumor of sacrum and mediastinal tumor. Out of 333 cases, 39 cases were non-malignant hematological disorders, in which 12 cases showed reactive changes secondary to reactive process or drug induced followed by Iron deficiency anemia (7) and infection (6). Spectrum of malignant diseases was shown in table (1) Non-Hodgkin's lymphoma exhibited 15 B cell non Hodgkin lymphoma in which 5 were mantle cell lymphoma, 5 were follicular lymphoma and 1 T cell non Hodgkin lymphoma.…”

Section: Table 1 Age-wise Distribution Of Hematological Disorders In ...mentioning

confidence: 99%

Pattern of malignant hematological disorders using bone marrow aspirate and biopsy at tertiary care hospital, Karachi.

Mehwish Sajjad,

Shaheen Kouser,

Taha Khan

et al. 2022

j Muhammad Med Coll

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Introduction: Bone marrow aspirate and biopsy is an invasive method for identification, staging, and pursuing tumors. Current study designed to determine the frequency of malignant hematological disorders using bone marrow aspirate and biopsy at Dr. Ishrat ul Ebad Khan Institute of Blood Diseases (DIEKIBD).Objectives: To determine the frequencies of various hematological disorders usingbone marrow aspiration and trephine biopsy examinationMethodology: In this retrospective study, 333 patients presenting at DIEKIBD during January 2019 to December 2020 were included. All these patients underwentbone marrow examination and the reports were retrieved from the departmentrecords.Result: It was observed that about 80 (24%) of the bone marrow examinationswere done for staging in which 8 (2.4%) were not illustrated any primary diseasesinvolvement while 72 cases (21%) contained primary diseases. Among nonmalignant conditions, iron deficiency anemia, megaloblastic anemia and mixed deficiency anemia were the most frequent, while acute lymphoblastic leukemia, acutemyeloid leukemia and chronic myeloid leukemia were the most prevalent malignanthematological disorders.Conclusion: Pathological analysis of Bone Marrow via Aspirate and Trephine biopsy is a widespread approach in diagnosing, staging and prognosis of neoplastic aswell as non-neoplastic hematological disorders. Bone Marrow biopsy examinationanalysis has a significant value in the diagnosis and staging of malignant conditionsthan non-malignant disorder as in our study prevalence of malignant conditionswere more than non-malignant diseases. Key words: Bone Marrow Biopsy, Blood Disorder, Malignant Hematological Diseases.

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Utility of repeating bone marrow biopsy for confirmation of complete response in multiple myeloma

Cited by 6 publications

References 7 publications

Feasibility of artificial intelligence–supported assessment of bone marrow infiltration using dual-energy computed tomography in patients with evidence of monoclonal protein — a retrospective observational study

Feasibility of artificial intelligence–supported assessment of bone marrow infiltration using dual-energy computed tomography in patients with evidence of monoclonal protein — a retrospective observational study

Frequency of Hematological Malignancies Based on Bone-Marrow Aspiration and Trephine Biopsy in Patients Presenting to Tertiary Care Hospital

Pattern of malignant hematological disorders using bone marrow aspirate and biopsy at tertiary care hospital, Karachi.

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