Bone marrow and blood involvement by non-Hodgkin’s lymphoma: Clinicopathologic features and prognostic significance in relationship to the Working Formulation

  • E. Morra
  • M. Lazzarino
  • E. Orlandi
  • D. Inverardi
  • A. Castello
  • A. Coci
  • U. Magrini
  • C. Bernasconi
Part of the Developments in Oncology book series (DION, volume 32)


Bone marrow (BM) biopsy is a valuable staging procedure for patients with malignant non-Hodgkin’s lymphomas (NHL). In cases presenting with nodal involvement, a positive bone marrow finding would allow diagnosis of Stage IV disease without the need for more aggressive procedures. Previous studies have evaluated the frequency and pattern of bone marrow involvement in the various pathologic subtypes of the NHL classified according to the Rappaport [1–5], Lukes and Collins [6, 7], and Kiel [8–11] schemes. Furthermore, the results of Bartl’s study [10] applying the Kiel classification to BM biopsies, indicated the prognostic significance of BM disease in NHL. As concerns peripheral blood involvement by malignant lymphomas, the leukemic phase has been the subject of several studies, all based on the Rappaport [12–14], Lukes and Collins [7], WHO [15, 16] and Kiel systems [17].


Malignant Lymphoma Bone Marrow Biopsy Hairy Cell Leukemia Bone Marrow Involvement Actuarial Survival 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Rappaport H (1966). Tumor of the hematopoietic system. In: Atlas of Tumor Pathology, section 3, fascicle 8. Washington DC: US Armed Forces Institute of Pathology.Google Scholar
  2. 2.
    Dick R, Bloomfield CD and Brunning RD (1974). Incidence, cytology, and hystopathology of non-Hodgkin’s lymphomas in the bone marrow. Cancer 33:1382–1398.PubMedCrossRefGoogle Scholar
  3. 3.
    McKenna RW, Bloomfield CD and Brunning RD (1975). Nodular lymphoma and blood manifestations. Cancer 36:428–440.CrossRefGoogle Scholar
  4. 4.
    Stein RS, Ultmann JE, Byrne GE et a1. (1976). Bone marrow involvement in the non-Hodgkin’s lymphoma. Cancer 37:629–636.PubMedCrossRefGoogle Scholar
  5. 5.
    Coller BS, Chabner BA and Gralnick HR (1977). Frequencies and patterns of bone marrow involvement in non-Hodgkin lymphomas: Observations on the value of bilateral biopsies. Amer J Hemat 3:105–119.Google Scholar
  6. 6.
    Lukes RJ and Collins RD (1974). Immunological characterization of human malignant lymphomas. Cancer 34:1488–1503.PubMedCrossRefGoogle Scholar
  7. 7.
    Foucar F, McKenna R, Frizzera G and Brunning RD (1982). Bone marrow and blood involvement by lymphoma in relationship to the Lukes-Collins classification. Cancer 49:888–897.PubMedCrossRefGoogle Scholar
  8. 8.
    Lennert K, Mohri N, Stein H and Kaiserling E (1975). The histopathology of malignant lymphoma. Br J Haemat (suppl) 31:193–203.CrossRefGoogle Scholar
  9. 9.
    Lennert K, Mohri N, Stein H et al. (1978). Malignant lymphomas other than Hodgkin’s disease. Histology-Cytology-Ultrastructure. Immunology. Berlin, Heidelberg, New York: Springer Verlag.Google Scholar
  10. 10.
    Bartl R, Frisch B, Burkhardt R et al. (1982). Assessment of bone marrow histology in the malignant lymphomas (non-Hodgkin’s). Correlation with clinical factors for diagnosis, prognosis, classification and staging. Br J Haematol 51:511–530.PubMedCrossRefGoogle Scholar
  11. 11.
    Brusamolino R, Magrini U, Canevari A et al. (1983). Low-grade malignancy non-Hodgkin’s lymphomas: Prognostic relevance of their clinicopathologic heterogeneity. Tumori 69:331–338.PubMedGoogle Scholar
  12. 12.
    Schnitzer B, Loesel LS and Reed RE (1970). Lymphosarcoma cell leukemia: A clinicopathologic study. Cancer 26:1082–1096.PubMedCrossRefGoogle Scholar
  13. 13.
    Come SE, Jaffe ES, Andersen JC et al. (1980). Non-Hodgkin’s lymphomas in leukemic phase: Clinicopathologic correlations. Amer J Med 69:667–674.PubMedCrossRefGoogle Scholar
  14. 14.
    Fram RJ, Skarin AT, Rosenthal DS et al. (1983). Clinical, pathologic and immunologic features of patients with non-Hodgkin’s lymphoma in a leukemic phase. A retrospective analysis of 34 patients. Cancer 52:1220–1228.PubMedCrossRefGoogle Scholar
  15. 15.
    Mathé G, Rappaport H, O’Connor GT and Torlini H (1976). Histological typing of neoplastic diseases of haematopoietic and lymphoid tissues. In: WHO International Histological Classification of Tumors, n. 14 Geneva World Health Organization.Google Scholar
  16. 16.
    Mathé G, Misset JL, Gil-Delgado M and De Vassal F (1978). Leukemic (or stage V) lymphosarcoma. In: Mathé G, Seligmann M and Tubiana M (Eds.). Recent Results in Cancer Research, Lymphoid Neoplasias. II. Clinical and Therapeutic Aspects, pp. 88–107. Berlin, Heidelberg, New York: Springer Verlag.Google Scholar
  17. 17.
    Mona E, Lazzarino M, Orlandi E et al. (1984). Leukemic phase of non-Hodgkin’s lymphoma. Hematological features and prognostic significance. Hematologica 69:15–29.Google Scholar
  18. 18.
    The Non-Hodgkin’s Lymphoma Pathologic Classification Project. (1982). National Cancer Institute sponsored study of classifications of non-Hodgkin’s lymphomas. Cancer 49:2112–2135.CrossRefGoogle Scholar
  19. 19.
    Magrini U, Castello A, Bossi A and Ascari E (1978). Allestimento della biopsia osteomidollare. In: Introzzi P. (Ed.). Trattata italiano di medicina interna. III, pp. 2323–2327. USES, Firenze.Google Scholar
  20. 20.
    Berkson J and Gage RP (1950). Calculation of survival rates for cancer. Proc Staff Meet Mayo Clin 25:270–278.PubMedGoogle Scholar
  21. 21.
    Gehan EA (1965). A generalized Wilcoxon test for comparing singly censored samples. Biometrika 52:203–223.PubMedGoogle Scholar
  22. 22.
    Straus DJ, Filippa DA, Liebermann PH et al. (1983). The non-Hodgkin’s lymphomas. A retrospective clinical and pathologic analysis of 499’ cases diagnosed between 1958 and 1969. Cancer 51:101–109.PubMedCrossRefGoogle Scholar
  23. 23.
    Jones SE, Rosenberg SA and Kaplan HS (1972). Non-Hodgkin’s lymphomas. I: Bone marrow involvement. Cancer 29:954–960.PubMedCrossRefGoogle Scholar
  24. 24.
    Galton DAG, Catowsky D and Wiltshaw E (1978). Clinical spectrum of lympho-proliferative diseases. Cancer 42:901–910.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers, Boston 1985

Authors and Affiliations

  • E. Morra
    • 1
  • M. Lazzarino
    • 1
  • E. Orlandi
    • 1
  • D. Inverardi
    • 1
  • A. Castello
    • 2
  • A. Coci
    • 2
  • U. Magrini
    • 2
  • C. Bernasconi
    • 1
  1. 1.Divisione di EmatologiaOspedale Policlinico San MatteoPaviaItaly
  2. 2.Istituto di Anatomia ed Istologia PatologicaUniversità di PaviaPaviaItaly

Personalised recommendations