The value of routine bone marrow biopsy in patients with diffuse large B-cell lymphoma staged with PET/CT: a Danish-Canadian study
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The value of routine bone marrow biopsy in patients with diffuse large B-cell lymphoma staged with PET/CT : a Danish-Canadian study. / Alzahrani, M; El-Galaly, T C; Hutchings, M; Hansen, J W; Loft, A; Johnsen, H E; Iyer, V; Wilson, D; Sehn, L H; Savage, K J; Connors, J M; Gascoyne, R D; Johansen, P; Clasen-Linde, E; Brown, P; Villa, D.
In: Annals of Oncology, Vol. 27, No. 6, 06.2016, p. 1095-9.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The value of routine bone marrow biopsy in patients with diffuse large B-cell lymphoma staged with PET/CT
T2 - a Danish-Canadian study
AU - Alzahrani, M
AU - El-Galaly, T C
AU - Hutchings, M
AU - Hansen, J W
AU - Loft, A
AU - Johnsen, H E
AU - Iyer, V
AU - Wilson, D
AU - Sehn, L H
AU - Savage, K J
AU - Connors, J M
AU - Gascoyne, R D
AU - Johansen, P
AU - Clasen-Linde, E
AU - Brown, P
AU - Villa, D
N1 - © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2016/6
Y1 - 2016/6
N2 - BACKGROUND: The added diagnostic and prognostic value of routine bone marrow biopsy (BMB) in patients with diffuse large B-cell lymphoma (DLBCL) undergoing positron emission tomography combined with computed tomography (PET/CT) staging is controversial.PATIENTS AND METHODS: Patients with newly diagnosed DLBCL who underwent both staging PET/CT and BMB were retrospectively identified in British Columbia, Aalborg, and Copenhagen. Original written PET/CT and pathology reports were retrospectively reviewed to determine Ann Arbor stage and outcomes, with and without the contribution of BMB.RESULTS: A total of 530 patients were identified: 146 (28%) had focal bone marrow (BM) lesions on PET/CT and 87 (16%) had positive BMB. Fifty-two of 146 patients (36%) with positive PET/CT had a positive BMB [39 DLBCL, 13 indolent non-Hodgkin lymphoma (iNHL)], while 35 of 384 patients (9%) with negative PET/CT had positive BMB (12 DLBCL, 23 iNHL). BMB upstaged 12/209 (6%) of stage I/II patients to stage IV, although this was the case for only 3 (1%) patients with DLBCL in the BMB. PET/CT identified BM involvement by BMB with sensitivity 60%, specificity 79%, positive predictive value 36%, and negative predictive value 91%. Concordant histological involvement of the BM by DLBCL was associated with worse overall survival and progression-free survival than discordant or no involvement in univariate and multivariate analyses.CONCLUSIONS: In patients with DLBCL, staging PET/CT can miss BM involvement with concordant DLBCL (less common) or discordant iNHL (more common). Routine BMB does not add relevant diagnostic or prognostic value over PET/CT alone in the majority of patients with DLBCL.
AB - BACKGROUND: The added diagnostic and prognostic value of routine bone marrow biopsy (BMB) in patients with diffuse large B-cell lymphoma (DLBCL) undergoing positron emission tomography combined with computed tomography (PET/CT) staging is controversial.PATIENTS AND METHODS: Patients with newly diagnosed DLBCL who underwent both staging PET/CT and BMB were retrospectively identified in British Columbia, Aalborg, and Copenhagen. Original written PET/CT and pathology reports were retrospectively reviewed to determine Ann Arbor stage and outcomes, with and without the contribution of BMB.RESULTS: A total of 530 patients were identified: 146 (28%) had focal bone marrow (BM) lesions on PET/CT and 87 (16%) had positive BMB. Fifty-two of 146 patients (36%) with positive PET/CT had a positive BMB [39 DLBCL, 13 indolent non-Hodgkin lymphoma (iNHL)], while 35 of 384 patients (9%) with negative PET/CT had positive BMB (12 DLBCL, 23 iNHL). BMB upstaged 12/209 (6%) of stage I/II patients to stage IV, although this was the case for only 3 (1%) patients with DLBCL in the BMB. PET/CT identified BM involvement by BMB with sensitivity 60%, specificity 79%, positive predictive value 36%, and negative predictive value 91%. Concordant histological involvement of the BM by DLBCL was associated with worse overall survival and progression-free survival than discordant or no involvement in univariate and multivariate analyses.CONCLUSIONS: In patients with DLBCL, staging PET/CT can miss BM involvement with concordant DLBCL (less common) or discordant iNHL (more common). Routine BMB does not add relevant diagnostic or prognostic value over PET/CT alone in the majority of patients with DLBCL.
KW - Journal Article
U2 - 10.1093/annonc/mdw137
DO - 10.1093/annonc/mdw137
M3 - Journal article
C2 - 27002106
VL - 27
SP - 1095
EP - 1099
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 6
ER -
ID: 179291377