Bone marrow and blood involvement by non-Hodgkin's lymphoma: A study of clinicopathologic correlations and prognostic significance in relationship to the working formulation

E. Morra, M. Lazzarino, A. Castello, D. Inverardi, A. Coci, G. Pagnucco, E. Orlandi, S. Merante, U. Magrini, G. Zei, C. Bernasconi

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In a series of 172 patients with non-Hodgkin's lymphoma (NHL) classified according to the Working Formulation (WF) the overall incidence of bone marrow infiltration (BM+) at diagnosis was 39% : 59% for low-grade (LGML), 30% for intermediate-grade (IGML), and 25% for high-grade malignant lymphomas (HGML). The features most significantly correlated with the presence of BM+ were a low grade of histological malignancy, the degree of splenomegaly and high values of LDH, while those correlated with the extent of BM+ were a non-focal pattern of BM disease, the presence of blood involvement at diagnosis, and the degree of BM fibrosis. Blood involvement was detected at diagnosis in 13% of patients, and a further 16% developed a leukemic phase during the course of the disease. Blood involvement correlated significantly with splenomegaly, bulky disease, advanced clinical stage, and extent of BM+. The presence of BM infiltration 'per se' at diagnosis did not significantly affect prognosis. However, the extent of BM disease was correlated with a poorer outcome in IGML and HGML patients. Regarding peripheral blood involvement, LGML patients only late leukemic conversions were significantly associated with a worse prognosis. In patients with IGML and HGML, either initial or subsequent blood involvement was correlated with significantly poorer outcome.

Original languageEnglish
Pages (from-to)445-453
Number of pages9
JournalEuropean Journal of Haematology
Issue number5
Publication statusPublished - 1989


ASJC Scopus subject areas

  • Hematology

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