CLINICAL FACTORS PREDICTIVE OF BONE-MARROW INVOLVEMENT IN HODGKINS-DISEASE

The role of bone marrow biopsy in the staging of Hodgkin's disease is undergoing reevaluation. We have studied the relationship of clinical factors to the presence of bone marrow involvement in 130 previously u ntreated patients with Hodgkin's disease. The presence of fever, splee n enlargement, anemia, leukopenia, poor performance status and poor hi stologic subgroups were positively correlated with the presence of bon e marrow involvement in the univariate analysis. In the multivariate a nalysis, only fever, spleen involvement, leukopenia and poor histologi c subgroups were significant. The predictive value of the absence of f ever in regard to the absence of bone marrow involvement was 98%. The likelihood of bone marrow involvement in the absence of all four signi ficant factors was only 0.05%. Patients without these clinical factors should probably not be submitted to a bone marrow biopsy as part of t he staging procedures performed in Hodgkin's disease.