Publication Date:
2011-11-18
Description:
Abstract 2627 Accurate staging is essential for the optimal choice of first-line treatment in Hodgkin lymphoma (HL). Bone marrow biopsy (BMB) is still widely recommended as part of the routine staging workup. However, this procedure may not be necessary for patients staged with [18]F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT). The aims of this study were; 1) to determine if bone marrow infiltration can be excluded based on staging PET/CT result, and 2) to investigate whether BMB still adds useful information in the PET/CT era. Patients with newly diagnosed HL undergoing pre-therapeutic staging at three Danish university centers were eligible for inclusion in this retrospective study, provided both PET/CT and BMB were performed at staging. Patients were identified in the Danish Lymphoma Registry (LYFO). BMB results were first obtained from LYFO and validated by a review of local pathology records. PET/CT records were retrieved and reviewed. The patterns of skeletal FDG uptake were categorized as follows: 1) uni-focal, 2) bi-focal, 3) multi-focal or 4) diffuse homogeneous FDG uptake. Clinical stage and risk assessment were performed with and without the account of BMB results, according to the Ann Arbor classification, the International Prognostic Score (IPS), and the German Hodgkin Study Group risk criteria for limited disease. A total of 392 HL patients (Aalborg = 59, Aarhus = 67, Rigshospitalet = 266) were included, of whom 372 patients had classical HL and 20 had nodular lymphocyte predominant HL. According to staging PET/CT, 203 patients had limited stage disease and 189 patients had advanced stage disease. The median age at diagnosis was 39 years (range 15–87) and the female:male ratio was 3/4. BMB was positive for HL in 24 patients (6%), all of whom had been independently assessed by PET/CT as stage III (n=5) or IV (n=19) disease. Thus, no patients with PET/CT stage I-II disease, irrespective of the presence of B-symptoms, had HL infiltration in the BMB (p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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