scholarly journals BONE MARROW INFILTRATION ASSESSMENT BY FDG 18 ‐PET: CAN THIS IMAGING TEST REPLACE BONE MARROW TREPHINE BIOPSY IN DIFFUSE LARGE B CELL LYMPHOMA STAGING?

2021 ◽  
Vol 39 (S2) ◽  
Author(s):  
S. Duarte ◽  
C. Afonso ◽  
B. Marques ◽  
C. Barros Lima ◽  
D. Neves ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Bone Marrow Infiltration ◽  
Trephine Biopsy ◽  
Bone Marrow Trephine ◽  
Bone Marrow Trephine Biopsy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

R-CHOP21 Vs R-CHOP14 in Diffuse Large B-Cell Lymphoma Patients: Results From a Multicentre Retrospective Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1626-1626
Author(s):  
Luigi Rigacci ◽  
Alberto Fabbri ◽  
Benedetta Puccini ◽  
Enrico Orciuolo ◽  
Alice Pietrini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
High Risk ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Bone Marrow Infiltration ◽  
Advanced Stage ◽  
Symptomatic Disease ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Abstract 1626 Diffuse large B cell lymphoma (DLBCL) is one of the most common types of non-Hodgkin's lymphoma. R-CHOP21 (C21) is considered the standard therapy but a large number of studies tested R-CHOP14 (C14). The aim of our study was to evaluate retrospectively a cohort of patients (pts) treated with C21 or C14. All pts with diagnosis of DLBCL or follicular grade IIIb lymphoma, treated with curative intent were accrued. From January 2002 to December 2010, 123 pts were treated with C21 and 142 were treated with C14. The median age was 63 (range 19–89). The two cohorts of pts were balanced for all clinical characteristics a part for age (<65 or >64 years) with more aged pts in C21 arm (p 0.000), PS with more advanced PS (2–3) in C21 arm (0.000) and LDH value which was more frequently elevated in C14 arm (p: 0.002). After induction therapy 190 pts (71%) obtained a complete remission: 82/123 (67%) after C21 and 108/142 (75%) after C14. After a median period of observation of 31 months 81 pts relapsed, 42 (51%) in the C21 arm and 39 (36%) in the C14 arm. Considering the two therapies, C21 vs C14, no differences were reported in OS, PFS and DFS: 61% vs 68%, 59% vs 58% and 74% vs 61% respectively. In univariate analysis OS was lower in older pts (p: 0.02), advanced stage (p: 0.02), symptomatic disease (p: 0.05), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.02) and intermediate or high risk IPI (p: 0.000); PFS was lower in advanced stage (p: 0.002), symptomatic disease (p: 0.009), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.001) and intermediate high risk IPI (p: 0.000). In multivariate analysis OS was significantly better in low-intermediate IPI risk pts (p: 0.000) and in pts treated with C14 (p: 0.02); the PFS was better in low-intermediate IPI risk pts (p: 0.000). Considering only pts with low or low-intermediate IPI we observed that OS was significantly superior in the group treated with C14 (90% vs 64% p: 0.03), moreover in young pts (< 65 years) OS was better in pts treated with C14 (81% vs 58% p: 0.05). As expected hematological grade III/IV toxicity was more frequent in pts treated with C14, all pts but three (2%) completed the therapy without delay or dose reduction. No differences in extra-hematological toxicity were observed. Conclusions: In conclusion our results confirm that C14 do not improve the results of the standard C21 in the whole lymphoma population but in a subset of pts, young and low/intermediate risk pts, the C14 scheme seems to improve the OS. We will enlarge the cohort of studied patients but further prospective randomized studies are needed to verify this preliminary observations. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Prognostic significance of bone marrow infiltration detected by PET-CT in newly diagnosed diffuse large B cell lymphoma

Oncotarget ◽  
2016 ◽  
Vol 7 (14) ◽  
pp. 19072-19080 ◽  
Author(s):  
Jin-Hua Liang ◽  
Jin Sun ◽  
Li Wang ◽  
Lei Fan ◽  
Yao-Yu Chen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Bone Marrow Infiltration ◽  
Newly Diagnosed ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Large B Cell

scholarly journals Precision of Histological Bone Marrow Staging in Follicular Lymphoma and Diffuse Large B-cell Lymphoma

2012 ◽  
Vol 35 (6) ◽  
pp. 358 ◽  
Author(s):  
Titi Chen ◽  
Anne McDonald ◽  
Bruce Shadbolt ◽  
Dipti Talaulikar
Keyword(s):  
Bone Marrow ◽  
Follicular Lymphoma ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Weighted Kappa ◽  
Observer Agreement ◽  
Trephine Biopsy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Introduction: In Non-Hodgkin Lymphoma (NHL), bone marrow histology is the gold standard against which ancillary investigations such as immunophenotyping and gene rearrangement studies are interpreted. There is currently no data on the reproducibility of histological findings. This study was conducted to determine the rates of inter- and intra-observer agreement in histological detection of bone marrow involvement in the two major subtypes of NHL, Diffuse Large B-cell Lymphoma (DLBCL), and Follicular Lymphoma (FL). Methods: The bone marrow slides of randomly selected DLBCL and FL cases were independently examined by two hematologists using standardized reporting criteria on two occasions at least two weeks apart. Samples included both aspirate and trephine biopsy slides. Weighted kappa statistics were used to examine agreement for the discrete measures. Results: Weighted kappa analyses showed variable inter-observer agreement in 38 DLBCL cases [aspirate=0.52; trephine= 0.77] and 38 FL cases [aspirate=0.48; trephine=0.77]. Conclusion: Overall, higher agreement rates were noted with trephine biopsies than with aspirates. Except for the high intra-observer agreement on trephine biopsy assessment in FL, there is poor agreement in histological staging of both FL and DLBCL which demonstrates the limitations of histological diagnosis and the futility of interpreting ancillary tests against histology.

scholarly journals Bone marrow infiltration by flow cytometry at diffuse large B‐cell lymphoma NOS diagnosis implies worse prognosis without considering bone marrow histology

2019 ◽  
Vol 98 (6) ◽  
pp. 525-528 ◽  
Author(s):  
Fernando Martín‐Moro ◽  
Miguel Piris‐Villaespesa ◽  
Juan Marquet‐Palomanes ◽  
Mónica García‐Cosío ◽  
Jesús Villarrubia ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Bone Marrow Infiltration ◽  
Bone Marrow Histology ◽  
Large B Cell Lymphoma ◽  
Worse Prognosis ◽  
Large B Cell

Bone Marrow Biopsy for the Staging of Diffuse Large B-Cell Lymphoma: Is It Necessary Bilateral Trephine Biopsy?.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4427-4427
Author(s):  
Marcelo Bellesso ◽  
Rodrigo D. Velasques ◽  
Luis F. Pracchia ◽  
Beatriz Beitler ◽  
Vera L. Aldred ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Median Number ◽  
Trephine Biopsy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract In this retrospective analysis we study the usefulness of bilateral rather than unilateral iliac trephine biopsies in demonstrating Diffuse Large B-Cell Lymphoma (DLBCL) in the bone marrow (BM). A total of 28 DLBCL cases with BM infiltration were investigated with bilateral iliac trephine biopsy during staging. Our propose was to evaluate the incidence of unilateral BM involvement, and we compare the BM biopsy size with negative and positive BM infiltration. In 28 cases studied it was analyzed 70 BM fragments. These fragments were reviewed separately by pathologist about size and infiltration. In this group, 6 cases (21.4%) were unilaterally positive. The median number of fragment per case was 2.5; the median size of BM fragment was 11.01 mm (± 5.12) and BM fragment per case was 27.53mm. It was not found difference between size BM fragment in negative or positive fragments 11,57mm (±5.2) versus 10.95mm (±5.1), p>0.05, respectively. In 24 cases it was possible to compare negative and positive BM infiltration with age, sex, LDH and computerized tomography (CT) staging. In addition, it was not found difference between unilateral and bilateral BM infiltration about LDH and age, and CT. (Table 1). Conclusion: Although in unilateral infiltration cases did not change risk factor in International Prognostic Index (stage III–IV) by CT, we conclude that bilateral trephine biopsy is superior to unilateral, because bilateral biopsy could increase by 21,4% the detection of BM involvement by DLBCL, without difference between the size in negative versus positive fragments. Table 1. Distribution of Unilateral and Bilateral Bone Marrow infiltration by categories Unilateral infiltration (%) Bilateral infiltration (%) Age < 60 21% 50% Age ≥ 60 4% 25% Sex Male 16% 29% Sex Female 8% 47% CT staging I–II - 35% CT staging III–IV 26% 39% LDH Normal 8% 34% LDH Elevated 16% 42%

The Utility of Positron Emission Tomography (PET) with 18Fluorodeoxyglucose (18F-FDG) Compared to Standard Procedures in Detecting Bone Marrow Infiltration in Diffuse Large B-Cell Lymphoma in Developing Countries.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5015-5015
Author(s):  
Marcelo Bellesso ◽  
Renata Oliveira Costa ◽  
Flavia Dias Xavier ◽  
José Claudio Meneguetti ◽  
Felipe Vieira Rodrigues Maciel ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Developing Countries ◽  
B Cell ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Bone Marrow Infiltration ◽  
Large B Cell Lymphoma ◽  
Initial Staging ◽  
Large B Cell

Abstract Abstract 5015 Background Computed tomography (CT) scanning and bone marrow biopsy (BMB) are the most used methods for initial staging in Diffuse Large B-cell Lymphoma (DLBCL) in developing countries. In the United States and Europe, 18-FDG PET has demonstrated to be an essential imaging modality for initial staging, early response and final therapeutic assessment in DLBCL patients. Afterward BM biopsy (BMB) is the gold standard to detect BM infiltration in lymphoma. However the ability of the FDG-PET to assess bone marrow (BM) positivity in DLBCL has been investigated and remains a controversial issue in the literature. For that reason we retrospectively compared the BM infiltration by bilateral BMB with FDG-PET at diagnosis in DLBCL patients. Methods We evaluated retrospectively 38 patients with DLBCL reporting the number of true-positive, false-positive, true-negative, and false-negative BM positivity by FDG-PET having the bilateral BMB as a reference standard. Results Out of 38, BM(+) was detected in 4 (10.5%) patients by BMB and in 14 (36.8%) patients by FDG-PET. The sensitivity and specificity of FDG-PET to recognize BM infiltration were respectively 100% and 71%. Negative and positive predictive values of the FDG-PET to identify BM(+) were respectively 100% and 28.5%. In negative-BMB patients, a positive FDG-PET BM was found in iliac 1 (10%), vertebra 5 (50%), sternum 2 (20%), scapula 1 (10%) and femur 1 (10%). The 18FDG mean maximum standardized uptake value (SUVmax) was 6.85 ± 3.9 in negative-BMB group and 9.77 ± 3.2 in positive-BMB group, p=0,208. Conclusion These results suggest that FDG-PET has a good sensitivity in detecting bone marrow infiltration in this type of aggressive lymphoma when compared to bilateral BMB to our knowledge the standard procedure to evaluate BM infiltration in lymphoma staging. Even though this study has several limitations such as one single center experience, a small number of patients and the lack of FDG-PET BM(+) confirmation by guided biopsy in previously negative-BMB patients, the majority of publications have been made in developed countries, and moreover we believe many issues still remain to be answered such as data regarding the FDG-PET cost-effectiveness out of clinical trails, specially in developing countries, in order to elucidate whether these results will be translated into a real benefit in overall survival for these patients. Disclosures No relevant conflicts of interest to declare.

Bcl-2/IgH Expression of Diffuse Large B-cell Lymphoma Cells in Minimal Bone Marrow Infiltration

2014 ◽  
Vol 60 (06/2014) ◽  
Author(s):  
Yi-Qun Che ◽  
Peng Liu ◽  
Yang Luo ◽  
Di Shen ◽  
Jia-Jie Hao ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Bone Marrow Infiltration ◽  
Lymphoma Cells ◽  
Large B Cell Lymphoma ◽  
Large B Cell
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