Abstract

Two hundred and eighteen untreated patients with non-Hodgkin's lymphomas, classified according to the scheme of Rappaport et al., were investigated for bone marrow involvement. No pattern of pretreatment laboratory abnormalities predicted which patients would have a positive bone marrow for lymphoma. Open marrow biopsy demonstrated lymphoma after needle biopsy was negative, and both biopsy techniques were clearly superior to bone marrow aspiration in identifying marrow involvement. Bone marrow involvement correlated with advanced stage, cellular composition of the lymphoma, and, in the nodular lymphomas, splenomegaly and constitutional symptoms. Patients with histiocytic lymphomas uncommonly had initial marrow involvement whereas patients with mixed and lymphocytic types were frequently affected. Nodular or diffuse patterns did not influence the incidence of marrow involvement, but patients with nodular lymphomas and positive marrows survived significantly longer than those with diffuse lymphomas.

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