Comparison Of Methods For Detecting Bone Marrow Involvement In Diffuse Large B-cell Lymphoma

Objective:This study compared and evaluated the value of bone marrow smear(BMA),bone marrow biopsy(BMB),flow cytometry(FCM),karyotype analysis,IG gene rearrangement(GR)on bone marrow infiltration of DLBCL.Methods:We retrospectively analyzed the clinical data of 300 newly diagnosed DLBCL patients,and the detection rate,sensitivity and specificity of BMA,BMB,FCM and GR were compared,then drawn the ROC curve.Survival analysis was performed in 267 patients receiving R-CHOP(or R-CHOP-like)regimen.Results:Among 300 newly diagnosed DLBCL patients,14 cases were positive for BMA,26 cases were positive for BMB,46 cases were positive for FCM,40 cases were positive for GR,47 cases were positive for FCM and GR.The consistency of FCM combined GR with was the best,with κ coefficient of 0.675.The ROC curve indicated that the sensitivity of FCM was the best(90.9%)and the specificity of GR was the best(94.7%).Compared with the area under the curve(AUC)corrected by bonferroni,the diagnostic efficiency of FCM was better than that of BMA(P=0.014).BMB positive group,FCM positive group,GR positive group,FCM combined with GR positive group were adverse prognostic factors for OS and PFS,while FCM positive group,GR positive group,and FCM combined with GR positive group were independent adverse prognostic factors.Conclusions:1.FCM,GR and their combination are important methods to detect BMI in patients with DLBCL,which have better prognostic value than BMB.2.The survival time of patients with chromosome abnormalities is significantly shorter than that of normal patients,which has a certain prognostic value.3.Bone marrow examination is indispensable for newly diagnosed DLBCL patients.