International Journal of Hematology and Oncology 2019, Vol 29, Num 4 Page(s): 238-245
Non-Hematologic Malignancies Metastasing to the Bone Marrow: A Record-Based Descriptive Study From A Tertiary Center

Pelin AYTAN1, Nazım Emrah KOCER2, Mahmut YERAL1, Cigdem GEREKLIOGLU1, Mutlu KASAR1, Nur Hilal BUYUKKURT1, Suheyl ASMA1, Hakan OZDOGU3, Can BOGA1

1Adana Baskent University, Faculty of Medicine, Department of Hematology, Adult Bone Marrow Transplantation Unit, Adana, TURKEY
2Adana Baskent University, Faculty of Medicine, Department of Pathology, Adana, TURKEY
3Adana Baskent University, Faculty of Medicine, Department of Family Medicine, Adana, TURKEY

Keywords: Non-hematologic malignancy, Bone marrow, Biopsy, Aspiration
The aim of this study is to assess the cases of nonhematologic malignancies that had bone marrow (BM) metastasis with respect to hematologic abnormalities, radiologic findings and pathologic findings. All of the patients with BM investigation were retrospectively evaluated. The patients with BM metastasis by a non-hematologic malignancy were assessed. Data regarding patient characteristics including peripheral blood evaluation findings, imaging findings, BM evaluation results and survival were obtained from patient files and computer based electronic database. 30 cases were detected among 1831 BM aspirations and biopsies. The most common malignancies were breast (36.7%), prostate (13.3%), gastric(13.3%) and lung (13.3%) adenocarcinomas. 90.9% and 75% of the cases had positive radiologic findings with PET/CT and CT respectively. 43.3% of the patients died during the study period and the median time from BM assessment to death was 2 months. Anemia, thrombocytopenia and leukopenia were present in 90%, 73.3% and 20% respectively. Lactate dehydrogenase and alkaline phosphatase were elevated in 90% and 80% respectively. In 76.2% a leukoerythroblastic blood picture was present. All the cases were diagnosed with biopsy and aspiration detected infiltration in 40% and in 4 metastatic patients (13.3%) the aspiration was false negative. In 46.7% the aspiration resulted with dry tap. Grade 3 fibrosis was present in 76.7%. BM assessment is a minimally invasive technique and provides very beneficial clinical data, however, because the survival is very short after BM assessment and the PET/CT has a considerable sensitivity it is not necessary to confirm BM metastasis in patients whose tumor stage is already known.