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What do we miss and get if we replace bone marrow biopsy in DLBCL with staging PET/CT

Publication

Abstract

DLBCL is the most frequent type of lymphoma taking around 40% of all non-Hodgkin lymphomas. Assessing of bone marrow involvement (BMI) during staging of the disease is important for clinical stage determination.

According to new guidelines (Cheson et al., J Clin Oncol 2014; 32: 3059-3067) bone marrow biopsy (BMB) is no longer required and FDG PET substitutes it. We analyzed retrospectively 217 [112 men and 105 women, median age 65 years (21-87 years)] consecutive patients with newly diagnosed DLBCL between 2011 and 2014 who had available staging BMB and FDG PET.

PET was evaluated visually. Increased FDG uptake was considered as positive finding.

Positive PET findings were divided into 2 groups, focal and diffuse. BMB was evaluated histologically.

Type of involvement (concordat or discordant) and percentage of malignant cells was determined. Particular findings were compared; impact to clinical stage (CS) and outcome of treatment was analyzed.