BONE-MARROW STAGING IN PATIENTS WITH NON-HODGKINS-LYMPHOMA - IS FLOW-CYTOMETRY A USEFUL TEST

BACKGROUND. Flow cytometric analysis of bone marrow often is used as a n adjunct to morphologic evaluation in the staging of patients with no n-Hodgkin's lymphoma [NHL]. The goal of this study was to define objec tively the benefit of flow cytometry in this setting. METHODS. The aut hors reviewed retrospectively all bone marrow specimens submitted betw een January 1992 and December 1994 to the Washington University Depart ment of Pathology for flow cytometric immunophenotyping to rule out NH L. Results of morphologic examination and flow cytometry were reviewed independently and the ability to detect bone marrow involvement compa red. RESULTS, Two hundred and seventy-three bone marrow specimens from 190 patients with an established diagnosis of NHL were submitted for now cytometric analysis at initial presentation, restaging, and/or rec urrence. Morphologic evaluation was negative in 69%, positive in 23%, and equivocal in 8%. Flow cytometry was negative in all but 1 morpholo gically negative bone marrow specimens and 40% of morphologically invo lved bone marrow specimens. Two of 23 morphologically equivocal bone m arrow specimens were positive by flow cytometry. an additional 86 spec imens were obtained to rule out NHL in patients without an established diagnosis of NHL. The majority of patients had a history of human imm unodeficiency virus infection, cytopenia, or unexplained fevers. Morph ologically, one specimen was involved with NHL, 5 were equivocal, and 80 were negative. All specimens were negative by flow cytometry. CONCL USIONS. In this study, flow cytometric analysis improved the detection of NHL in bone marrow in only 3 of 273 samples, 2 of which were suspi cious morphologically. Flow cytometry of bone marrow aspirates has a l imited role in the routine staging and follow-up of patients with an e stablished diagnosis of NHL. (C) 1998 American Cancer Society.