The prognostic significance of bone marrow involvement in diffuse large B cell lymphoma according to the flow cytometry

Abstract

The significance of minimal bone marrow (BM) involvement in diffuse large B cell lymphoma (DLBCL), as determined by flow cytometry (FC), is unclear. Patient outcomes were retrospectively analyzed based on their BM biopsy and FC involvement. Eighty-one patients were included, 21 and 51 were positive for biopsy(B+) and FC(FC+) respectively. B+ FC+ patients had a 52.3%CR rate, the B− FC+ group had 76.7%, and the B− FC− had 73.3%. Mean time to progression (TTP) was 67.45, 76.8, and 79.3 months and median overall survival (OS) was 54.4, 76.6 and 69.5 months for the B+ FC+, B− FC+, and B− FC− groups respectively. A cutoff of 1% pathologic cells was an independent risk factor for TTP. In a multivariable analysis including International Prognostic Index (IPI), sex and HB, FC+ was independently associated with TTP (but not OS) at 5 years (HR 2.64, 95%CI 1.03–6.77) and at 7 years(HR 2.83, 95%CI 1.08–7.39). In summary, FC determined minimal involvement may suggest an intermediate risk group of DLBCL patients.

Keywords:

• Diffuse large B cell lymphoma
• prognostication
• minimal involvement
• flow cytometry

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The work of G.S. is supported in part by the Israel Ministry of Aliyah and Immigrant Absorption.