Presentation is loading. Please wait.

Presentation is loading. Please wait.

UTILITY OF BONE MARROW ASPIRATION AND BIOPSY (BMAB) IN INITIAL STAGING OF EWING SARCOMA (EWS) Lisa M. Kopp, Winston W. Huh, Cynthia E. Herzog, Chengcheng.

Similar presentations


Presentation on theme: "UTILITY OF BONE MARROW ASPIRATION AND BIOPSY (BMAB) IN INITIAL STAGING OF EWING SARCOMA (EWS) Lisa M. Kopp, Winston W. Huh, Cynthia E. Herzog, Chengcheng."— Presentation transcript:

1 UTILITY OF BONE MARROW ASPIRATION AND BIOPSY (BMAB) IN INITIAL STAGING OF EWING SARCOMA (EWS) Lisa M. Kopp, Winston W. Huh, Cynthia E. Herzog, Chengcheng Hu, Andrea White-Collins, Beatriz Rozo, Angela Yarborough, Pooja Hingorani

2 Background Pediatric and adolescents patients with newly diagnosed Ewing Sarcoma (EWS) have a bilateral bone marrow aspiration and biopsy (BMAB) performed as part of the initial staging evaluation BMAB is a painful procedure that is performed using general anesthesia

3 Background The NCCN guidelines on bone cancer recommend the option of either a BMAB or MRI of the spine and pelvis in newly diagnosed adult patients The necessity of a BMAB in staging pediatric and adolescent EWS patients in addition to radiological evaluation has not been previously established

4 Objectives To evaluate the association between imaging determined non-metastatic EWS and BM metastasis in pediatric and adolescent patients To evaluate the association between BM metastasis and other clinical characteristics of pediatric and adolescent EWS patients

5 Methods Retrospective review involving 3 institutions Eligibility: Patients less than 40 years of age with newly diagnosed EWS between the years ; available initial staging scans and BM evaluation 116 patients Initial staging reviewed – –Imaging (MRI primary site, CT chest, Bone scan) – –Bone Marrow Aspiration and Biopsy

6 Patient Characteristics Non-metastatic (n=85) Metastatic (n=31) Gender Male Female 47 (55.3%) 38 (44.7%) 18 (58.1%) 13 (41.9%) Age at Diagnosis* 13 (1, 38)16 (3, 25) Primary Tumor Site Pelvis Non-pelvis 15 (17.6%) 70 (82.4%) 14 (45.2%) 17 (54.8%) Primary Tumor Size (cm)*, **7.5 (1.3, 26.0)11.2 (3.5, 35.0) * Median (range) ** Primary tumor size of metastatic patients was significantly higher that that of non- metastatic patients (p-value = by Wilcoxon rank-sum test)

7 Metastatic Patients Metastatic site: Patients with multiple metastatic sites: Lung aloneBone aloneBM aloneMultiple 13 (41.9%)2 (6.5%)0 (0.0%)16 (51.6%) LungBoneBMLymph Nodes 9 (56.3%)14 (87.5%)13 (81.3%)2 (12.5%)

8 BMAB Results None of the 85 non-metastatic patients determined by imaging had positive BMAB A positive pelvic primary site was not correlated with a positive bone marrow BMAB Correlation with pelvic primary site (n=116) PelvicNon-PelvicP-value BMAB positive BMAB negative 2380

9 BMAB Results 13 of 31 metastatic patients by imaging had positive BMAB Number of Bony Metastatic Sites (bone scan, n=28) BMAB positiveBMAB negativeP-value 3.5 (1.0, 11.0)0.0 (0.0, 2.0)<

10 Association of Metastasis by Imaging and BMAB BMAB Results Bone MetastasisLung Metastasis YesNoYesNo Positive12167 Negative P-value for association* *Fisher’s exact test was used to evaluate association.

11 Conclusion Pediatric and adolescent Ewing sarcoma patients with non-metastatic disease by imaging may have a bone marrow aspiration and biopsy eliminated as part of initial staging In patients with metastatic disease there is a high correlation between bone marrow metastasis and the number of bony metastatic sites

12 Acknowledgments University of Arizona Phoenix Children’s Hospital – Pooja Hingorani, MD – Andrea White-Collins, NP University of Arizona – Mel and Enid Zuckerman College of Public Health – Chengcheng Hu, PhD University of Texas MD Anderson Cancer Center Children’s Cancer Hospital – Winston W. Huh, MD – Cynthia E. Herzog, MD, MPH – Beatriz Rozo, NP – Angela Yarbarough, NP


Download ppt "UTILITY OF BONE MARROW ASPIRATION AND BIOPSY (BMAB) IN INITIAL STAGING OF EWING SARCOMA (EWS) Lisa M. Kopp, Winston W. Huh, Cynthia E. Herzog, Chengcheng."

Similar presentations


Ads by Google