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Detecting Bone Marrow Involvement in DLBCL
Clin Lymphoma Myeloma Leuk; ePub 2017 Jun 16; Vishnu, et al
PET-CT can accurately detect lymphomatous bone marrow involvement in patients with diffuse large B cell lymphoma (DLBCL), according to a study involving 90 individuals. Participants were diagnosed with DLBCL between 2004 and 2013. Investigators looked for bone marrow involvement using PET-CT with and without the contribution of bone marrow aspirate/biopsy (BMAB). Among the results:
- One-fourth of patients had bone marrow involvement established by PET-CT; 14% by BMAB; and 12% by both methods.
- Half of the patients with positive PET-CT had bone marrow involvement by DLBCL.
- Only 3% with negative PET-CT showed bone marrow involvement.
- BMAB upstaged 2% of stage I/II patients to stage IV.
- The sensitivity and specificity of PET-CT to detect bone marrow involvement by DLBCL was 86% and 87%, respectively.
- The positive predictive value of PET-CT was only 50%, while the negative predictive value was 98%.
Vishnu P, Wingerson A, Lee M, Mandelson M, Aboulafia D. Utility of bone marrow biopsy and aspirate for staging of diffuse large B cell lymphoma in the era of positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-d-glucose integrated with computed tomography. [Published online ahead of print June 16, 2017]. Clin Lymphoma Myeloma Leuk. doi:10.1016/j.clml.2017.06.010.