Pattern of Bone Marrow Involvement in B-cell Non-Hodgkin’s Lymphoma - Experience from a Tertiary Care Center in North India

Abstract

Background: Bone marrow (BM) examination is an important investigation for staging or primary diagnosis of malignant lymphomas. The frequency of BM infiltration by lymphoma is quite variable. There are limited data available from developing countries on the pattern of BM involvement in patients of non-Hodgkin’s lymphoma (NHL). The aim of this study was to see the pattern of BM involvement by B-Cell NHL from a Tertiary Care Hospital in North India. Materials and Methods: All cases of B-cell NHL with BM involvement were included in this study. Peripheral blood smear, BM aspiration, and biopsy were performed for diagnosis and staging in all patients. Results: A total of 43 patients were diagnosed as B-cell NHL on BM aspiration and biopsy. The median age of our patients was 54.26 ± 15.07 years with a male: female ratio of 2.9:1. Twenty-four were indolent B-cell NHL cases and 19 patients had aggressive B-cell NHL. Indolent lymphomas such as SLL/CLL, MCL, FL, and marginal zone lymphoma are more common compared to aggressive NHL such as DLBCL and Burkitt’s lymphoma. Indolent lymphoma was more common in females than males (37.5% vs. 10.5%). The classical B-symptoms were present in 32.6% (n = 14). The BM was hypercellular in 62.8% of cases (n = 27) and cellular in 14% (n = 6). The pattern of BM biopsy involvement was diffuse in 65.1% (n = 28), interstitial in 23.3% (n = 10), and nodular in 11.6% (n = 5). Diffuse involvement of marrow was more frequent than nodular in aggressive lymphomas compared to indolent ones. Conclusions: In patients with B-cell NHL, BM involvement is more common in the indolent disease. The pattern of diffuse marrow involvement is more common in our region.

Keywords

• aggressive non-hodgkin’s lymphoma
• b-cell non-hodgkin’s lymphoma
• bone marrow aspiration
• bone marrow biopsy
• low-grade non-hodgkin’s lymphoma