Abstract
Solid cancers with bone marrow metastases are rare but lethal. This study aimed to identify clinical factors predictive of survival in adult patients with solid cancers and bone marrow metastases. A total of 83 patients were enrolled consecutively between January 1, 2000 and December 31, 2012. Bone marrow metastases were confirmed by biopsies. Patient clinical features and laboratory data were analyzed for associations. The median age of the patients was 54 years (range, 23-88 years), and 58% were male. The 3 most common primary tumor locations were the stomach (32 patients, 39%), prostate (16 patients, 19%), and lungs (12 patients, 15%). The median overall survival was 49 days (range, 3-1423 days). Patients with Eastern Cooperative Oncology Group performance status 1, cancers of prostate origin, platelet counts over 50,000/ml, and undergoing antitumor therapies had a significantly better prognosis in the multivariate analysis. The median survival times were 173 and 33 days for patients with 2-3 more favorable parameters (n=24) and those with 0-1 (n=69), respectively (hazard ratio 0.30; 95% CI 0.17-0.52, p<0.001). Solid cancers with bone marrow metastases are dismal and incurable diseases. Understanding prognostic factors to these diseases helps medical personnel to provide appropriate treatments and better inform patients about outcomes. Antitumor therapies may improve outcomes in selected patient cohorts.
Highlights
Solid cancer with bone marrow metastases is a rare but lethal condition (Ringenberg et al, 1986; Wang et al, 1987; Papac RJ, 1994; Ozkalemkas et al, 2005; Kim et al, 2007; Kwon et al, 2011)
This study aimed to identify clinical factors predictive of survival in adult patients with solid cancers and bone marrow metastases
Bone marrow biopsy has been the standard diagnostic modality for overt bone marrow metastases arising from solid cancers since 1958 when McFarland and Dameshek first described a simplified technique for bone marrow biopsy (McFarland et al, 1958)
Summary
Solid cancer with bone marrow metastases is a rare but lethal condition (Ringenberg et al, 1986; Wang et al, 1987; Papac RJ, 1994; Ozkalemkas et al, 2005; Kim et al, 2007; Kwon et al, 2011). Only small cases series of patients with solid cancers and bone marrow metastases are reported in the literature. Among these reports, malignancies of the prostate, breast, lungs, and stomach were the primary tumors that most frequently metastasized to the bone marrow (Hansen et al, 1971; Shah et al, 1985; Ceci et al, 1988; Tritz et al, 1989; Diel et al, 1992; Trillet-Lenoir et al, 1994; Kim et al, 2007; Kwon et al, 2011; Mehdi et al, 2011). Reports about the clinical features and outcomes of patients with solid cancers with bone marrow metastases are limited. The timing of the diagnosis and clinical presentation of overt bone marrow metastases in solid cancers varies widely. This study aimed to identify clinical factors predictive of survival in adult patients with solid cancers and bone marrow metastases.
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