Abstract 630P
Background
Diffuse large B-cell lymphoma (DLBCL) is the most common disease subtype of malignant lymphoma. Bone marrow involvement (BMI)is closely related to the prognosis of DLBCL. In order to explore the diagnostic and prognostic value of bone marrow aspirate detection for BMI in DLBCL, a single center retrospective study was conducted for patients with newly diagnosed DLBCL to investigate the diagnostic efficacy and prognostic value of bone marrow aspirate detection (flow cytometry, immunoglobulin heavy chain (IGH) or light chain (IGL) gene rearrangement, chromosome karyotype analysis and bone marrow morphology).
Methods
A total of 307 patients with newly diagnosed DLBCL were included. The detection rates of BMI in bone marrow biopsy (BMB), flow cytometry (FCM), Ig gene rearrangement (GR), chromosome karyotype analysis and BM morphology were counted. Taking BMB as the gold standard, the consistency, sensitivity and specificity of BM aspirate detection were observed, and the ROC curve was drawn. The overall survival (OS) and progression free survival (PFS) of patients were counted and the survival of positive group and their negative control groups were compared.
Results
BMI was detected in 26 (8.5%), 46 (15.0%), 40 (13.0%), 25 (8.1%) and 14 (4.6%) patients by BMB, FCM, Ig gene rearrangement, chromosome karyotype analysis and BM smear, respectively. Consistency rate κ is 0.626, 0.595, 0.508 and 0.628 respectively. The detection rate of BMI by FCM and GR of bone marrow aspirates is higher. The sensitivity of BMI by FCM is 88.5%, the specificity is 95%, the Jordan index is 83.5%, and the area under the curve （AUC） is 0.928. The survival rates (OS and PFS) of BMB positive group, FCM positive group and GR positive group were lower than those of negative control group (P < 0.05). The survival curves of chromosome karyotyping positive group and BM smear positive group showed poor prognosis, but there was no significant difference.
Conclusions
The detection of bone marrow aspirate has important diagnostic and prognostic value for BMI of DLBCL, which is in good agreement with BMB. Among them, FCM and GR methods have good diagnostic efficiency and can suggest poor prognosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
K. Zhao.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.