Original Research

Factors associated with bone marrow involvement in lymphoma staging bone marrow examination: A South African single-centre retrospective study

Robert K. Lohlun, Zivanai C. Chapanduka
South African Journal of Oncology | Vol 6 | a211 | DOI: https://doi.org/10.4102/sajo.v6i0.211 | © 2022 Robert K. Lohlun, Zivanai C. Chapanduka | This work is licensed under CC Attribution 4.0
Submitted: 05 December 2021 | Published: 23 August 2022

About the author(s)

Robert K. Lohlun, Department of Haematology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Department of Haematology, National Health Laboratory Services, Tygerberg Hospital, Cape Town, South Africa
Zivanai C. Chapanduka, Department of Haematology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Department of Haematology, National Health Laboratory Services, Tygerberg Hospital, Cape Town, South Africa


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Abstract

Background: Accurate detection of bone marrow involvement (BMI) in lymphoma is important as it signifies stage 4 disease. Staging bone marrow examination (BME), therefore, influences treatment decisions and prognostication. The prevalence of BMI depends on multiple factors at presentation including lymphoma subtype, age, sex, human immunodeficiency virus (HIV) status and haematological parameters.

Aim: To determine risk factors for BMI in lymphoma staging.

Setting: The study was conducted in the department of haematological pathology, Tygerberg Hospital, Cape Town, South Africa.

Methods: Retrospective cross-sectional descriptive study in adult patients, reviewing BMI and associated parameters, during their initial lymphoma staging procedure between 2016 and 2019.

Results: Of a total of 387 lymphoma staging cases that were evaluated, 30.0% of them showed BMI. Diffuse large B-cell lymphoma, Hodgkin lymphoma and high-grade B-cell lymphoma were the most frequent subtypes diagnosed. The highest prevalence of BMI was in low-grade lymphomas. There was a statistically significant association between BMI and advanced age, pancytopenia and bicytopenia (anaemia with leucopenia, anaemia with thrombocytopenia or leucopenia with thrombocytopenia). Bicytopenia and pancytopenia showed high positive predictive values of BMI, respectively, 61.0% and 69.0%. Human immunodeficiency virus positivity (34.6%) was not predictive of BMI across all lymphoma subtypes. Normal blood counts had a high negative predictive value for BMI.

Conclusion: BME remains an important part of lymphoma staging with 30.0% of all lymphomas showing BMI.


Keywords

lymphoma staging; bone marrow involvement; HIV

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