Graff Emily C, Spangler Elizabeth A, Smith Annette, Denhere Melody, Brauss Minerva
Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
Vet Clin Pathol. 2014 Dec;43(4):505-12. doi: 10.1111/vcp.12182. Epub 2014 Aug 19.
Evaluation of the bone marrow is needed for complete staging in dogs with multicentric large-cell lymphoma, but is often omitted in clinical practice.
The objective was to determine if routine peripheral blood findings, including microscopic evaluation of blood smears, can predict the presence of bone marrow involvement in dogs with lymphoma.
Hematologic data including evaluation of blood smears and bone marrow aspirates from 107 dogs newly diagnosed with large-cell lymphoma were retrospectively evaluated. Neoplastic lymphocytes were identified based on cell size, nuclear size, chromatin pattern, and the presence of nucleoli. Positive specimens were defined as having ≥ 10% neoplastic lymphocytes. Two groups were established based on the presence or absence of lymphoma in the bone marrow. Variables (positive blood smear, HCT, platelet count, and total and differential WBC counts) were evaluated to determine if they were predictive of bone marrow involvement using univariate and multivariate logistic models.
Thrombocytopenia and the presence of > 10% neoplastic lymphocytes on blood smears were identified as significant variables for predicting the presence of bone marrow involvement. When considered independently, either a positive blood smear or thrombocytopenia had low sensitivity (60%) and moderate specificity (89% and 87%, respectively). Sensitivity increased when these variables were evaluated together (80%).
In dogs with multicentric large-cell lymphoma, thrombocytopenia or the presence of neoplastic lymphocytes in circulation is suggestive of bone marrow involvement, but not definitive. Normal peripheral blood findings do not exclude the possibility of lymphoma in the bone marrow.
对于多中心大细胞淋巴瘤犬进行完整分期需要评估骨髓情况,但在临床实践中这一检查常被省略。
确定常规外周血检查结果,包括血涂片显微镜评估,是否能够预测淋巴瘤犬骨髓受累情况。
回顾性评估了107只新诊断为大细胞淋巴瘤犬的血液学数据,包括血涂片和骨髓穿刺液评估。根据细胞大小、核大小、染色质模式和核仁情况识别肿瘤性淋巴细胞。阳性标本定义为肿瘤性淋巴细胞≥10%。根据骨髓中是否存在淋巴瘤建立两组。使用单变量和多变量逻辑模型评估变量(血涂片阳性、红细胞压积、血小板计数、白细胞总数及分类计数),以确定它们是否可预测骨髓受累情况。
血小板减少和血涂片上肿瘤性淋巴细胞>10%被确定为预测骨髓受累的显著变量。单独考虑时,血涂片阳性或血小板减少的敏感性均较低(60%),特异性中等(分别为89%和87%)。当一起评估这些变量时,敏感性增加(80%)。
在多中心大细胞淋巴瘤犬中,血小板减少或循环中存在肿瘤性淋巴细胞提示骨髓受累,但不能确诊。外周血检查结果正常不能排除骨髓淋巴瘤的可能性。