Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Ann Lab Med. 2013 Mar;33(2):89-96. doi: 10.3343/alm.2013.33.2.89. Epub 2013 Feb 21.
The prognostic impact of the presence of differentiating neuroblasts in bone marrow (BM) remains unclear in BM metastatic neuroblastoma (NB). We aimed to identify the prognostic impact of differentiating neuroblasts in BM at diagnosis and after chemotherapy.
A total of 51 patients diagnosed with BM metastatic NB at Asan Medical Center between January 1990 and July 2005 were enrolled. BM histology and laboratory data along with overall survival (OS) were compared with regard to the differentiation status of neuroblasts in BM at diagnosis and after chemotherapy.
Among the 51 patients, 13 (25.5%) exhibited differentiating neuroblasts in BM at diagnosis and 17/51 (33.3%) exhibited them after chemotherapy. The only significant difference among patient groups was the improved OS in patients with differentiated neuroblasts in BM at diagnosis (P=0.021). In contrast, the differentiation status of neuroblasts in BM after chemotherapy did not affect OS (P=0.852).
Our study is the first report describing the presence of differentiating neuroblasts in BM. The presence of differentiating neuroblasts in BM at diagnosis may be a favorable prognostic factor for patients with BM metastatic NB; however, the same phenomenon after chemotherapy is irrelevant to prognosis.
在骨髓转移神经母细胞瘤（NB）中，骨髓中存在分化神经母细胞的预后影响尚不清楚。我们旨在确定诊断时和化疗后骨髓中分化神经母细胞的预后影响。
共纳入 1990 年 1 月至 2005 年 7 月在 Asan 医疗中心诊断为骨髓转移 NB 的 51 例患者。比较了骨髓组织学和实验室数据以及总生存期（OS），以了解诊断时和化疗后骨髓中神经母细胞的分化状态。
在 51 例患者中，13 例（25.5%）在诊断时的骨髓中存在分化的神经母细胞，17/51 例（33.3%）在化疗后存在分化的神经母细胞。仅在诊断时骨髓中存在分化的神经母细胞的患者组之间存在显著差异（P=0.021）。相反，化疗后骨髓中神经母细胞的分化状态并不影响 OS（P=0.852）。
本研究首次报道了骨髓中存在分化的神经母细胞。诊断时骨髓中存在分化的神经母细胞可能是骨髓转移 NB 患者的有利预后因素；然而，化疗后出现同样的现象与预后无关。
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