Utility of bone marrow aspiration and biopsy in initial staging of Ewing sarcoma

Lisa M Kopp, Chengcheng Hu, Beatriz Rozo, Andrea White-Collins, Winston W. Huh, Angela Yarborough, Cynthia E. Herzog, Pooja Hingorani

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The current standard of care for initial staging of pediatric Ewing sarcoma (EWS) patients is to obtain a bilateral bone marrow aspiration and biopsy (BMAB). The incidence of bone marrow (BM) disease in patients deemed non-metastatic by conventional and metabolic imaging and the concordance of BM positivity with other clinical characteristics are not well established. Procedure: This study is a multi-institutional retrospective review of newly diagnosed EWS patients less than 40 years of age with initial staging that included imaging and BMAB. Results: A total of 116 patients were eligible with 85 patients considered non-metastatic and 31 considered metastatic by imaging. None of the 85 patients with non-metastatic disease were BMAB positive (0%; 95% CI: 0-4.2%); 13 of the 31 patients with metastases were BMAB positive (41.9%; 95% CI: 24.5-60.9%). Primary tumor size was significantly higher in patients with metastases (P=0.017). Bone metastasis by imaging had high correlation with BMAB positivity (P=0.0002). In addition, the number of bony metastatic sites was significantly higher in patients with a positive BMAB as compared to those with a negative BMAB (median 3.5 and 0.0, respectively; P<0.001). Conclusions: BMAB may not be required for initial staging of pediatric and young adult EWS patients deemed non-metastatic by imaging. In patients with metastatic disease, there is a high correlation of BM involvement with multiple bone metastases.

Original languageEnglish (US)
Pages (from-to)12-15
Number of pages4
JournalPediatric Blood and Cancer
Volume62
Issue number1
DOIs
StatePublished - Jan 1 2015

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Ewing's Sarcoma
Needle Biopsy
Bone Marrow
Bone Marrow Diseases
Neoplasm Metastasis
Pediatrics
Bone and Bones
Standard of Care
Young Adult

Keywords

  • Bone marrow aspiration
  • Bone marrow biopsy
  • Bone scan
  • Ewing sarcoma
  • Pediatrics
  • Staging

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Medicine(all)

Cite this

Utility of bone marrow aspiration and biopsy in initial staging of Ewing sarcoma. / Kopp, Lisa M; Hu, Chengcheng; Rozo, Beatriz; White-Collins, Andrea; Huh, Winston W.; Yarborough, Angela; Herzog, Cynthia E.; Hingorani, Pooja.

In: Pediatric Blood and Cancer, Vol. 62, No. 1, 01.01.2015, p. 12-15.

Research output: Contribution to journalArticle

Kopp, LM, Hu, C, Rozo, B, White-Collins, A, Huh, WW, Yarborough, A, Herzog, CE & Hingorani, P 2015, 'Utility of bone marrow aspiration and biopsy in initial staging of Ewing sarcoma', Pediatric Blood and Cancer, vol. 62, no. 1, pp. 12-15. https://doi.org/10.1002/pbc.25212
Kopp, Lisa M ; Hu, Chengcheng ; Rozo, Beatriz ; White-Collins, Andrea ; Huh, Winston W. ; Yarborough, Angela ; Herzog, Cynthia E. ; Hingorani, Pooja. / Utility of bone marrow aspiration and biopsy in initial staging of Ewing sarcoma. In: Pediatric Blood and Cancer. 2015 ; Vol. 62, No. 1. pp. 12-15.
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AU - Yarborough, Angela

AU - Herzog, Cynthia E.

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AB - Background: The current standard of care for initial staging of pediatric Ewing sarcoma (EWS) patients is to obtain a bilateral bone marrow aspiration and biopsy (BMAB). The incidence of bone marrow (BM) disease in patients deemed non-metastatic by conventional and metabolic imaging and the concordance of BM positivity with other clinical characteristics are not well established. Procedure: This study is a multi-institutional retrospective review of newly diagnosed EWS patients less than 40 years of age with initial staging that included imaging and BMAB. Results: A total of 116 patients were eligible with 85 patients considered non-metastatic and 31 considered metastatic by imaging. None of the 85 patients with non-metastatic disease were BMAB positive (0%; 95% CI: 0-4.2%); 13 of the 31 patients with metastases were BMAB positive (41.9%; 95% CI: 24.5-60.9%). Primary tumor size was significantly higher in patients with metastases (P=0.017). Bone metastasis by imaging had high correlation with BMAB positivity (P=0.0002). In addition, the number of bony metastatic sites was significantly higher in patients with a positive BMAB as compared to those with a negative BMAB (median 3.5 and 0.0, respectively; P<0.001). Conclusions: BMAB may not be required for initial staging of pediatric and young adult EWS patients deemed non-metastatic by imaging. In patients with metastatic disease, there is a high correlation of BM involvement with multiple bone metastases.

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