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Blood Res. 2018 Dec;53(4):281-287. English. Original Article. https://doi.org/10.5045/br.2018.53.4.281
Özpolat HT , Yilmaz E , Goksoy HS , Özpolat S , Dogan O , Unal SN , Nalcaci M .
Bloodworks Research Institute, Seattle, WA, USA. tahsino@bloodworksnw.org
Department of Nuclear Medicine, Istanbul School of Medicine, Istanbul, Turkey.
Department of Hematology, Istanbul School of Medicine, Istanbul, Turkey.
Department of Biostatistics and Epidemiology, Marmara School of Medicine, Istanbul, Turkey.
Department of Pathology, Istanbul School of Medicine, Istanbul, Turkey.
Abstract

Background

Bone marrow involvement (BMI) affects the lymphoma stage, survival, and treatment. Bone marrow biopsy (BMB) and fluorodeoxyglucose (FDG) positron emission tomography- computed tomography (PET/CT) are useful techniques to detect BMI. Both have advantages and disadvantages. We aimed to identify factors that could be used to predict BMI with positive and negative results on PET/CT compare them with BMB in newly diagnosed patients with lymphoma.

Methods

We included 22 non-Hodgkin and 16 Hodgkin lymphoma patients in this single center study. All patients had PET/CT examination and BMB before treatment. BMI in BMB was reported as negative or positive. Bone marrow was classified into 3 types by FDG uptake on PT/CT; diffuse involvement, focal involvement, and normal bone marrow.

Results

PET/CT and BMB results were concordant (7 positive, 15 negative) in 22 patients (57%). We evaluated concordant and discordant patient characteristics and risk-stratified patients for BMI. Our findings suggest that patients with diffuse FDG uptake on PET/CT, especially patients with advanced age and low platelet and white blood cell counts, are likely to have BMI and could potentially forego BMB. Patients with negative PET/CT findings and no significant laboratory abnormalities are very unlikely to have BMI.

Conclusion

Our results suggest that BMI should not be decided solely based PET/CT or BMB findings. It is reasonable to use both diagnostic assays along with clinical and laboratory findings. PET/CT result, clinical and laboratory findings could be useful for predicting BMI in patient for whom BMB is contraindicated.

Copyright © 2019. Korean Association of Medical Journal Editors.