Bone Marrow Biopsy Not Needed to Stage New Hodgkin's Patients, Says Study


A new study has been published in the Journal of Clinical Oncology which could have major implications for newly diagnosed Hodgkin's patients.

According to the study, patients who have treatment-naive Hodgkin's lymphoma and who have been staged using PET/CT imaging get no benefit from a bone marrow biopsy.

Currently, the National Comprehensive Cancer Network's oncology guidelines for Hodgkin's include a bone marrow biopsy as an essential aspect of a new patient's work-up if imaging shows them to have stage IB, IIB, III or IV disease.

Tarec Chistoffer El-Galaly, M.D., of Aarhus University Hospital in Denmark, and colleagues carried out a retrospective study involving 454 patients with newly diagnosed Hodgkin's to determine whether a bone marrow biopsy added anything of use to PET/CT staging or added anything of any therapeutic value to the patient.

What they found was that among patients initially diagnosed with stage I or II disease, none of these patients had bone marrow biopsies positive for disease. Just five of the patients who had been stage III according to PET/CT were upstaged following their bone marrow biopsy, but the upstaging didn't change their treatment plan.

"To the best of our knowledge, this is the largest study to date examining the value of BMB in patients with HL who are undergoing PET/CT staging. The added diagnostic value from routine BMB was minimal, and positive BMB findings implied upstaging in only five patients from stage III to stage IV disease of a total of 454 included patients."

Source: Doctor's Lounge

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