Study of Bone Marrow Involvement in 1161 Consecutive Hodgkin's Lymphoma Patients.

Reviewer: William Levin, MD
The Abramson Cancer Center of the University of Pennsylvania
Ultima Vez Modificado: 8 de diciembre del 2001

Presenter: Alessandro Lewis
Affiliation: Piemonte Hodgkin's Disease Registry. Alessandria, Italy

Background
  • In Hodgkin's Disease(HD) bone marrow involvement(BMI) has been reported as a unfavorable prognostic factor. Accordingly, bone marrow biopsy(BMB) is frequently used in staging of disease.
  • Increasingly, the utility of this procedure in early stage disease(Stage IA & IIA)has been questioned.
  • In this study the authors try to identify factors that predict for BMI, so that those patients at low risk can avoid BMB as a part of staging.
Materials and Methods
  • From 1982-2000, 1161 HD patients underwent BMB as a part of their staging.
  • Median age was 37 years old
  • 19% had bulky disease
  • 39% had B symptoms
  • 57% were male
  • 56% had supra-diaphragmatic involvement, 9% infra-diaphragmatic disease, and 35% with both
  • 59% had nodular sclerosis histology, 30% mixed cellularity, and 4% lymphocyte depleted
  • 946 patient cases underwent multivariate analysis in an attempt to identify factors related to BMI.
Results

Five main independent variables were identified that predicted for positive BMI:

  1. B symptoms
  2. infra-diaphragmatic involvement
  3. mixed cellularity or lymphocyte depleted histology
  4. more than 3 involved sites
  5. liver involvement.
Author's Conclusions
  • Predictive models based on these clinical factors could be formulated to
  • help identify those patients with a low risk of BMI, and thus avoid BMB in
  • these patients.
Clinical/Scientific Implications
  • Bone marrow biopsy is not a simple risk free procedure.
  • It can be very painful and anxiety provoking for the patient as well as be a potential source of serious infection.
  • Identifying those patients at very low risk for bone marrow involvemnt would help reduce the number of unecessary procedures in the staging of Hodgkin's Disease.

Blogs

Is Ayurveda the Answer to Women’s Health Issues?
by The 4Wholeness Team
September 01, 2015