If it is in the marrow, is it also in the blood? An analysis of 1,000 paired samples from patients with B-cell non-Hodgkin lymphoma

<p>Abstract</p> <p>Background</p> <p>Staging of B-cell non Hodgkin's lymphoma (NHL) routinely involves bone marrow (BM) examination by trephine biopsy (BM-TB). The evidence of disease in the BM-TB results in a clinical stage IV classification affecting therapeutic strategies for NHL patients. BM immunophenotyping by flow cytometry (FC) is also used, although its clinical value is still under debate.</p> <p>Methods</p> <p>Using FC we analyzed 1,000 paired BM aspirates and peripheral blood (PB) samples from 591 NHL patients to investigate the concordance between BM and PB. B-lymphocytes were defined monoclonal when a ratio of 0.3 < κ/l > 3 was observed. Aberrant immunophenotypes present in the B-cell subpopulation were also investigated. BM-TB was also performed in 84.1% of samples (841/1000), and concordance between BM-TB and BM-FC was evaluated. Concordance was defined as the presence of a positive (in terms of disease detection) or negative result in both BM-FC and PB-FC or BM-TB and BM-FC.</p> <p>Results</p> <p>Using FC, the overall concordance between BM and PB was 95%. Among the discordant cases (ie presence of neoplastic B-lymphocyte in the BM but under the sensibility of the technique in the PB) the most frequent diagnosis was Waldenstrom's macroglobulinemia (WM, accounting for 20.8% of all discordant cases). The expression of CXCR4, a receptor involved in B-cell trafficking and homing, was found to be down regulated in WM compared to other NHL types, thus suggesting a possible role of CXCR4 in WM cell homing in the BM. WM excluded, FC investigation of BM and PB in NHL patients gives overlapping information.</p> <p>BM involvement was observed by FC in 38% of samples, and concordance between BM-FC and BM-TB was 85%.</p> <p>Conclusions</p> <p>The finding that FC data from BM and PB samples overlap in NHL might have major implications for the design of future clinical studies and for patients' follow-up.</p

ČETVRTI SIMPOZIJUM MAGISTARA FARMACIJE TUZLANSKOG KANTONA "KOMPETENCIJE FARMACEUTA U PREVENCIJI INFEKCIJA I SUZBIJANJU REZISTENCIJE NA ANTIBIOTIKE"

SAŽECI RADOVA IZ PODRUČJA FARMAKOLOGIJE SA TOKSIKOLOGIJOM 4. Simpozijum «KOMPETENCIJE FARMACEUTA U PREVENCIJI INFEKCIJA I SUZBIJANJU REZISTENCIJE NA ANTIBIOTIKE» KOMORA MAGISTARA FARMACIJE TUZLANSKOG KANTON