title: Diagnostic and Prognostic Relevance of Bone Marrow Microenvironment Components in Non Hodgkin’s Lymphoma Cases Before and After Therapy
abstract: Objective: To evaluate stromal cells of the bone marrow microenvironment (BMM) in bone marrow trephine
  biopsy (BMTB) specimens, with a focus on fibronectin, tumor necrosis factor- alpha (TNF-α) and L-selectin in Non-
  Hodgkin’s lymphoma (NHL) patients, before and after therapy. Materials and Methods: A total of 80 de novo NHL
  patients, 64 with B-cell lymphomas 80% , (follicular cell lymphoma (FCL) in 32, chronic lymphocytic leukemia/
  small lymphocytic lymphoma (CLL/SLL) in 12, and diffuse large cell lymphoma in 20) and 16 with T-cell lymphomas
  (20%) all diagnosed as T-Lymphoblastic lymphomas, were evaluated before and after therapy. For comparison, 25
  age and sex matched BM donors, were included as a control group. BMTB material and BM aspirates were taken for
  morphological assessment of stromal cells, the plasma of these samples being examined for TNFα and L-selectin by
  ELISA, and fibronectin by radial immunodiffusion (RID). Results: BM stromal cells comprising reticular macrophages
  and fibroblasts were elevated in 53.3% of NHL cases at diagnosis, while BM fibronectin levels were decreased and
  BM TNFα and L-selectin were higher than in controls (p<0.05). In NHL cases, elevated values of BM TNFα and BM
  L-selectin were associated with signs of aggressive disease, including >1 extra nodal sites, detectable B symptoms, high
  grade, BM and CNS invasion, and a high International prognostic index (IPI) (p<0.05). Conclusion: BMM components,
  TNFα, L-selectin and fibronectin, in NHL can be useful in evaluating disease activity, extent and response to treatment
  and as prognostic markers according to the IPI.
authors.affiliation: Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt. Email:
  amirasoliman777@hotmail.com
authors.forename: Amira H
authors.initials: AH
authors.lastname: Soliman
keywords: Bone marrow microenvironment; trephine biopsy; stromal cells; fibronectin; TNF-alpha; L-selectin; NHL