Detection Of Malignant Lymphoma With Bone Marrow Involvement By Means Of Flow Cytometry

Background: Bone marrow involvement is easily found in malignant lymphoma. It is important to detect whether malignant lymphoma patients were caught with bone marrow involvement. Flow Cytometer (CD45/SSC gate) has already been applied to detect micro-metastasis disease of leukemia in bone marrow. Reports using this method in malignant lymphoma haven't been found up to now. In this study, we want to evaluate the clinical feasibility and value of Flow Cytometry on detecting malignant lymphoma with bone marrow involvement. Whether clinical stage and clinical character will be changed relating to bone marrow involvement.Objective: (1) TO found out a new method to detect malignant lymphoma patients with bone marrow involvement by means of Flow Cytometry. To analyze whether the change of clinical stage and clinical character are related to bone marrow involvement.Methods: Paired data of chi-square test design was adopted. Bone ftiarrow of malignant lymphoma patients was detected by Flow Cytometer(CD45/SSC gate), Bone marrow smear and biopsy was simultaneously performed as control .Value of Flow Cytometry was observed compared with bone marrow smear. Clinical character such as3sex, age, pathologic type, clinical stage, blood LDH level, status of PS score etc was collected at the same time.Results:(l) Bone marrow of 34 malignant lymphoma patients was examined by Flow Cytometer together with smear. 23 cases were detected to catch with bone marrow involvement through Flow Cytometry. Only 4 cases were found with bone marrow invasion by means of smear. The chi-square value was 17.05. Probability was small than 0.05 (p<0.05). (2) Among 23cases with bone marrow involvement through Flow Cytometry, 19 cases were non-Hodgkin's lymphoma (NHL) , 4 cases were Hodgkin's lymphoma(HL). The marker antigen of B cell NHL was CD19 and CD20, T cell NHL was CD7, and HL was CD9. (3) Clinical stage was changed after Flow Cytometry examination. Before examination, there were 3 cases in stage I, 16 cases in stage II, 4cases in stage III and 11 cases in stage IV. After examination, there were 2 cases in stage I, 7 cases in stage II, 1 case in stage III, 24 cases in stage IV. Probability was small than 0.05(p<0.05). (4) Clinical character of these 34 cases was collected, however, sex, age, clinical stage, blood LDH level, PS score etc had no statistical significant relation to bone marrow involvement(p>0.05).Conclusion: ( 1) Flow Cytometry (CD45/SSC gate) is a feasible and effective method to detect patients with bone marrow involvement. (2) The marker antigen of B cell NHL is CD19 and CD20, T cell NHL is CD7. And HL is CD9. (3) Flow Cytometry is super to conventional bone marrow smear. This method has changed clinical stage and can be4recommended to detected bone marrow invasion as a new method.