Search

The significance of minimal bone marrow (BM) involvement in diffuse large B cell lymphoma (DLBCL), as determined by flow cytometry (FC), is unclear. Patient outcomes were retrospectively analyzed based on their BM biopsy and FC involvement. Eighty-one patients were included, 21 and 51 were positive for biopsy(B+) and FC(FC+) respectively. B+ FC+ patients had a 52.3%CR rate, the B- FC+ group had 76.7%, and the B- FC- had 73.3%. Mean time to progression (TTP) was 67.45, 76.8, and 79.3 months and median Overall survival(OS) was 54.4, 76.6 and 69.5 months for the B+ FC+, B- FC+, and B- FC- groups respectively. A cutoff of 1% pathologic cells was an independent risk factor for TTP. In a multivariable analysis including International Prognostic Index (IPI), sex and HB, FC+ was independently associated with TTP (but not OS) at 5 years (HR 2.64, 95%CI 1.03-6.77) and at 7 years(HR 2.83, 95%CI 1.08-7.39). In summary, FC determined minimal involvement may suggest an intermediate risk group of DLBCL patients.

A non-invasive myelodysplastic syndromes (MDS) diagnostic model would allow for care while avoiding invasive bone marrow examinations (BME). BME-established MDS patients were compared to non-MDS (BME-excluded) patients. Variables (gender, age, hemoglobin (Hb), mean red blood cell corpuscular volume (MCV), platelet (PLT), and white blood cell (WBC)) were combined with multivariate logistic regression; a probability score (Y) was calculated. MDS (n = 48) and non-MDS (n = 63) patients were used to establish the model. The ROC was drawn, giving an AUC of 0.748 (95% CI: 0.656-0.84). Two cutoff values were used for Y. Y ≥ 0.633: high likelihood (positive predictive value (PPV) = 85%); Y ≤ 0.288: low likelihood (negative predictive value (NPV) = 81%) of MDS. The first group is defined as probable MDS (pMDS); the second, probably not MDS (pnMDS). The model was validated with 40 additional patients (20 with and 20 without MDS). Using clinical and lab data, we could diagnose or exclude MDS in about half of the patients, avoiding BME. Future work will use larger cohorts of patients to improve and further validate the model.