Routine Bone Marrow Biopsy Has Little or No Therapeutic Consequence for Positron Emission Tomography/Computed Tomography-Staged Treatment-Naive Patients With Hodgkin Lymphoma
Routine Bone Marrow Biopsy Has Little or No Therapeutic Consequence for Positron Emission Tomography/Computed Tomography-Staged Treatment-Naive Patients With Hodgkin Lymphoma
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DOI：
10.1200/jco.2012.42.4036
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发表时间：
2012-12-20
影响因子：
45.3
通讯作者：
Hutchings, Martin
中科院分区：
文献类型：
--
作者：
El-Galaly, Tarec Christoffer;d'Amore, Francesco;Hutchings, Martin
PurposeTo探讨骨髓活检（BMB）是否增加了有用的信息，[F-18]氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）分期患者霍奇金淋巴瘤（HL）Hodgkin lymphoma（HL）.Patients and MethodsNewly诊断的HL患者进行治疗前分期，包括PET/CT和BMB被纳入这项回顾性研究。骨骼FDG摄取模式分为单灶、双灶或多灶（>= 3处病变）。根据安阿伯分类和德国Hodgkin研究组的指南，确定临床分期，风险评估和治疗计划，有和没有BMB结果的贡献。ResultsA共454例HL患者，其中82例（18%）有局部骨骼PET/CT病变和27例（6%）有阳性BMB。通过PET/CT分期，没有BMB阳性患者被评估为I期至II期疾病。BMB使5名患者提前，在BMB之前被评估为III期;根据BMB结果，454名患者中没有一名被分配到另一种治疗。局灶性骨骼PET/CT病变识别阳性和阴性BMB的敏感性和特异性分别为85%和86%。病灶骨骼PET/CT病变BMB结果的阳性和阴性预测值分别为28%和99%，respectively.ConclusionA一致的发现，这项研究是没有阳性BMB PET/CT评估阶段I至II疾病。在454例新诊断的HL患者队列中，忽略BMB分期不会改变风险评估或治疗策略。J Clin Oncol 30：4508-4514. (C)2012年美国临床肿瘤学会
PurposeTo investigate whether bone marrow biopsy (BMB) adds useful information to [F-18]fluorodeoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) staging in patients with Hodgkin lymphoma (HL).Patients and MethodsNewly diagnosed patients with HL undergoing a pretherapeutic staging that encompasses both PET/CT and BMB were included in this retrospective study. The pattern of skeletal FDG uptake was categorized as uni-, bi-, or multifocal (>= three lesions). Clinical stage, risk assessment, and treatment plan were determined with and without the contribution of BMB results according to the Ann Arbor classification and the guidelines from the German Hodgkin Study Group.ResultsA total of 454 patients with HL were included of whom 82 (18%) had focal skeletal PET/CT lesions and 27 (6%) had positive BMB. No patients with positive BMB were assessed as having stage I to II disease by PET/CT staging. BMB upstaged five patients, assessed as being stage III before BMB; none of the 454 patients would have been allocated to another treatment on the basis of BMB results. Focal skeletal PET/CT lesions identified positive and negative BMBs with a sensitivity and specificity of 85% and 86%, respectively. The positive and negative predictive values of focal skeletal PET/CT lesions for BMB results were 28% and 99%, respectively.ConclusionA consistent finding of this study was the absence of positive BMBs in PET/CT-assessed stage I to II disease. The omission of staging BMB would not have changed the risk assessment or treatment strategy in this cohort of 454 newly diagnosed patients with HL. J Clin Oncol 30:4508-4514. (C) 2012 by American Society of Clinical Oncology