Lymphomas are the most common haematological malignancies, accounting for the 5% of all cancers in both genders. Incidence of Hodgkin lymphoma is about 2.8 new cases per 100,000 people per year; overall incidence of non-Hodgkin lymphomas is about 19.7 new cases per 100,000 people per year. Estimated 5-year survival rate depends on several factors: age at diagnosis (co-morbidity in older patients negatively affects prognosis), blood haemoglobin and serum LDH levels, presence of extra-nodal disease, and above all the initial stage of disease: about 90% in patients with stage I Hodgkin lymphoma; about 65% in patients with stage IV Hodgkin lymphoma. In non- Hodgkin lymphomas, survival rates may vary widely depending on the lymphoma type (aggressive or indolent) and the presence of the aforementioned risk factors: from 91% in low-risk patients to 53% in high-risk ones. However, in both Hodgkin and non-Hodgkin lymphomas, the evidence of bone marrow involvement indicates the highest Ann Arbor stage (stage IV) by itself, with several therapeutic implications. Therefore, the assessment of eventual bone marrow involvement is recommended in all patients with aggressive non- Hodgkin lymphoma, such as diffuse large B-cell lymphoma (DLBCL), that could benefit from curative treatment and in Hodgkin lymphoma, especially with stage III-IV disease or stage II disease with adverse risk factors, when a change in therapy planning is expected depending on the presence/absence of bone marrow disease.
Blind Bone Marrow Biopsy (BMB) of the iliac crest, either performed unilaterally or bilaterally, is the gold standard method for diagnosing bone marrow involvement in lymphomas and in other haematological entities, like multiple myeloma.
Giorgio Treglia, Bone Marrow Involvement in Hodgkin and Non-Hodgkin Lymphomas: The Role of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography
Last date updated on January, 2021