Bone marrow biopsy in diffuse large B-cell lymphoma: Useful or redundant test?

Figures & data

Table I. Characteristics of included patients.

	Positive BMB	Negative BMB
Patients	18	95
Age
Mean± SD (years)	68.2 ± 11.0	64.7 ± 14.6
Median (years)	69.0	68.0
Range (years)	44–83	24–88
Male/Female	8/10	53/42
Radiological stage
I	0	17
II	1	9
III	6	21
IV	11	48
NCCN-IPI risk factors
Stage III/IV disease*	17	69
Major extranodal involvement**	7	37
Age
≤ 40 years	0	7
> 40–≤ 60 years	5	23
> 60–≤ 75 years	7	42
> 75 years	6	23
ECOG PS > 1	5	14
LDH > ULN
≤ 1	3	32
> 1–≤ 3	13	52
> 3	2	11

*BMB-, CT- or FDG-PET/CT-based bone marrow involvement was ignored for the assessment of Ann Arbor stage; **Defined as either central nervous system, liver/gastrointestinal tract or lung involvement as recommended by Zhou et al. [9], positive BMB, FDG-PET/CT-based bone marrow involvement and CT-based cortical destruction were not counted as extranodal involvement.

BMB, bone marrow biopsy; ECOG PS, Eastern Cooperative Oncology Group Performance Score; LDH, lactate dehydrogenase; NCCN-IPI, National Comprehensive Cancer Network International Prognostic Index; SD, standard deviation; ULN, upper limit of normal (according to the local reference value of the participating institution).

Figure 1. Number of negative and positive BMBs among the different radiological-based Ann Arbor stages.

Table II. Cross-tabulation of NCCI-IPI-based risk stratification without versus with taking into account BMB results.

	NCCN-IPI risk group with taking into account BMB results
		Low	L-I	H-I	High
NCCN-IPI risk group without taking into account BMB results	Low	8	0	0	0
	L-I	0	26	5	0
	H-I	0	0	51	4
	High	0	0	0	19

H-I, high-intermediate; L-I, low-intermediate.

Zhou Z, Sehn LH, Rademaker AW, Gordon LI, Lacasce AS, Crosby-Thompson A, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood 2014;123:837–42.

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