title: The prognostic value of bone marrow involvement at the molecular level in aggressive lymphoma.
abstract: We retrospectively studied the prognostic role of molecular (gene rearrangement, GRR) bone marrow (BM) involvement in diffuse large B-cell lymphoma (DLBCL, 424 patients) and in peripheral T-cell lymphoma (PTCL, 67 patients). When correlating BM GRR to histological findings at diagnosis, the GRR test was more sensitive (p = 0.036) but less specific (p < 0.0001) in PTCL than in DLBCL. For DLBCL (but not PTCL), a positive BM GRR correlated with advanced stage (p = 0.0001) and high IPI (p = 0.002), and worsened the progression free survival (PFS) (p = 0.05) and overall survival (OS) (p = 0.01), irrespective of rituximab treatment. Histologic negative/GRR positive cases had worse PFS/OS (p < 0.0001) than histologic/GRR double negative cases, however BM GRR was not an independent prognostic survival factor. End-of-treatment BM GRR did not predict survival. We conclude that BM GRR is unjustified as a prognostic tool for PTCL and should be reserved for a subset of DLBCL patients with negative histology of the BM.
authors.affiliation: a Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Neta
authors.initials: N
authors.lastname: Goldschmidt
authors.affiliation: a Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Fares
authors.initials: F
authors.lastname: Darawshy
authors.affiliation: b School of Public Health, Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Geffen
authors.initials: G
authors.lastname: Kleinstern
authors.affiliation: a Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Elena
authors.initials: E
authors.lastname: Slyusarevsky
authors.affiliation: a Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Galina
authors.initials: G
authors.lastname: Pogrebijski
authors.affiliation: a Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Krichevsky
authors.affiliation: a Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Dina
authors.initials: D
authors.lastname: Ben-Yehuda
authors.affiliation: a Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel.
authors.forename: Moshe E
authors.initials: ME
authors.lastname: Gatt
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019046:Bone Marrow Neoplasms / Q000556:secondary*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000235:genetics / Q000401:mortality / Q000473:pathology; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy / Q000235:genetics / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Gene rearrangement; bone marrow; diffuse large B-cell lymphoma; peripheral T-cell lymphoma