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The value of routine bone marrow examination in patients with extranodal NK/T‐cell lymphoma staged with PET/CT
Author(s) -
Yang Yong,
Wang JiJin,
Zhao RuiZhi,
Huang Cheng,
Shi GuiQing,
Zheng Hao,
Tang TianLan,
Liao SiQin,
Chen JinHua,
Shen JianZhen,
Liu TingBo,
Xu BenHua,
Zhang YuJing
Publication year - 2022
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.34473
Subject(s) - medicine , bone marrow , lymphoma , radiology , bone marrow examination , nuclear medicine , pathology
Background Limited evidence supports the omission of routine bone marrow (BM) examination (biopsy and aspiration) in patients with nasal‐type extranodal NK/T‐cell lymphoma (ENKTCL). This study was aimed at assessing whether BM examination provides valuable information for positron emission tomography/computed tomography (PET/CT)–based staging in this patient population. Patients and Methods Patients newly diagnosed with ENKTCL who underwent initial staging with both PET/CT and BM examination between 2013 and 2020 were retrospectively identified in two Chinese institutions. Overall, 742 patients were included; the BM examination was positive in 67 patients. Results Compared with BM biopsy alone, the combination of BM biopsy and aspiration assessment did not afford any additional diagnostic value. No patient with a positive BM biopsy was found to have early‐stage disease by PET/CT. BM biopsy or PET/CT led to upstaging from stage III to IV as a result of BM involvement in 21 patients. In 135 patients with distant organ involvement, BM involvement was associated with worse overall survival (OS) and progression‐free survival (PFS) compared with the corresponding durations in patients without BM involvement (2‐year OS: 35.9% vs. 60.4%, p < .001; PFS: 26% vs. 40.7%, p = .003). No difference in survival was noted between groups judged positive based on PET/CT and BM biopsy. Conclusion Compared with aspiration, BM biopsy led to the detection of more BM lesions. Baseline PET/CT can be safely used to exclude BM involvement in early‐stage disease. Overall, routine BM examination affords diagnostic or prognostic value over PET/CT in patients with advanced‐stage nasal‐type ENKTCL.