Utility of bone marrow aspirate and biopsy in staging of patients with T-cell lymphoma in the PET-Era – tissue remains the issue

Abstract

The role of 18F-fluoro-2-deoxy-D-glucose positron emission tomography combined with computerized tomography (PET-CT) in evaluation of bone marrow involvement (BMI) in patients with T-cell lymphoma (TCL) is poorly understood. We investigated whether PET-CT could replace bone marrow aspiration and biopsy (BMAB) in TCL. Sixty patients with newly diagnosed TCL who underwent both diagnostic PET-CT and BMAB were identified. BMI was tissue-confirmed in 15 (25%) cases, however only 8 of these 15 showed BMI on PET-CT (sensitivity of 53.3%, specificity of 100%). BMI by BMAB was associated with lower progression-free survival (PFS) (p = 0.038) and overall survival (OS) (p = 0.003) while PET-CT BMI was associated only with OS (p = 0.02). BMI detected by BMAB in the setting of a negative PET-CT had similar inferior prognosis as BMI identified on PET-CT. Thus, PET-CT in TCL misses BMI in almost half of the cases detected by BMAB and hence cannot substitute BMAB in evaluation of TCL.

Keywords:

• T cell lymphoma
• PET scan
• bone marrow biopsy
• Positron emission tomography
• bone marrow involvement
• bone marrow evaluation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Roswell Park Cancer Institute and National Cancer Institute (NCI) grant P30CA016056.