Spector N, Nucci M, Oliveira De Morais J C, Maiolino A, Portugal R D, Costa M A, Pulcheri W
Hematology Service, University Hospital, Federal University of Rio de Janeiro, Brazil.
Leuk Lymphoma. 1997 Jun;26(1-2):171-6. doi: 10.3109/10428199709109172.
The role of bone marrow biopsy in the staging of Hodgkin's disease is undergoing reevaluation. We have studied the relationship of clinical factors to the presence of bone marrow involvement in 130 previously untreated patients with Hodgkin's disease. The presence of fever, spleen enlargement, anemia, leukopenia, poor performance status and poor histologic subgroups were positively correlated with the presence of bone marrow involvement in the univariate analysis. In the multivariate analysis, only fever, spleen involvement, leukopenia and poor histologic subgroups were significant. The predictive value of the absence of fever in regard to the absence of bone marrow involvement was 98%. The likelihood of bone marrow involvement in the absence of all four significant factors was only 0.05%. Patients without these clinical factors should probably not be submitted to a bone marrow biopsy as part of the staging procedures performed in Hodgkin's disease.
骨髓活检在霍奇金病分期中的作用正在重新评估。我们研究了130例未经治疗的霍奇金病患者临床因素与骨髓受累情况之间的关系。在单因素分析中，发热、脾肿大、贫血、白细胞减少、身体状况差和组织学亚型差与骨髓受累呈正相关。在多因素分析中，只有发热、脾受累、白细胞减少和组织学亚型差具有统计学意义。无发热对于无骨髓受累的预测价值为98%。在不存在所有四个显著因素的情况下，骨髓受累的可能性仅为0.05%。没有这些临床因素的患者可能不应接受骨髓活检作为霍奇金病分期程序的一部分。
