Routine use of ancillary investigations in staging diffuse large B-cell lymphoma improves the International Prognostic Index (IPI).

Journal of Hematology & Oncology
Dipti TalaulikarAnne McDonald

Abstract

The International Prognostic Index (IPI) is used to determine prognosis in diffuse large B-cell lymphoma (DLBCL). One of the determinants of IPI is the stage of disease with bone marrow involvement being classified as stage IV. For the IPI, involvement on bone marrow is traditionally defined on the basis of histology with ancillary investigations used only in difficult cases to aid histological diagnosis. This study aimed to determine the effect of the routine use of flow cytometry, immunohistochemistry and molecular studies in bone marrow staging upon the IPI. Bone marrow trephines of 156 histologically proven DLBCL cases at initial diagnosis were assessed on routine histology, and immunohistochemistry using two T-cell markers (CD45RO and CD3), two B-cell markers (CD20 and CD79a) and kappa and lambda light chains. Raw flow cytometry data on all samples were reanalysed and reinterpreted blindly. DNA extracted from archived paraffin-embedded trephine biopsy samples was used for immunoglobulin heavy chain and light chain gene rearrangement analysis. Using immunophenotyping (flow cytometry and immunohistochemistry), 30 (19.2%) cases were upstaged to stage IV. A further 8 (5.1%) cases were upstaged using molecular studies. A change...Continue Reading

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Citations

May 16, 2015·International Journal of Laboratory Hematology·E E TorlakovicUNKNOWN International Council for Standardization in Haematology
Sep 23, 2014·Journal of Clinical Pathology·Ellen BergetOlav Karsten Vintermyr
Oct 18, 2016·Medicine·Chao LiWen-Chan Li
Feb 8, 2018·Clinical Journal of Gastroenterology·Takakazu MiyakeHiroshi Nakase
Jul 28, 2016·Terapevticheskiĭ arkhiv·O A GavrilinaV G Savchenko

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Methods Mentioned

BETA
biopsies
biopsy
flow cytometry
PCR
electrophoresis

Software Mentioned

Invivo
Statistical Package for Social Sciences ( SPSS )
BIOMED2

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