Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Breitegger, B.
Bone marrow aspirations in Ewing sarcomas: are they still necessary?
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2015. pp. 64
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Holzer Lukas
- Leithner Andreas
- Urban Ernst-Christian
- Altmetrics:
- Abstract:
- Background: Currently, one of the most useful prognostic indicators in Ewing sarcomas (ES) is the presence of metastatic disease at diagnosis. According to clinical guidelines, including the 2012 ESMO clinical practice guidelines and the EURO Ewing 99 study protocol from 2006, the assessment of bone marrow (BM) metastases, using light microscopically examination of bone marrow aspirates and biopsies (BMAB) is, besides other imaging investigations, mandatory. However, the prognostic value of BM positivity is discussed controversially. Therefore, the primary objective of this study was to retrospectively review BM samples from patients with ES and, as second objective, to review published literature concerning BM examination in ES. Materials and Methods: This retrospective study included 31 ES patients that were newly diagnosed between 2000 and 2014 and that have therefore been treated at the Department for Orthopaedics and Orthopaedic Surgery at the University Hospital of Graz. Metastases at diagnosis were present in 5/31 patients. BM samples were collected from the iliac crest and were morphologically and immunohistochemically examined by the pathologists. These findings were searched and screened for the presence or absence of BM metastases. Furthermore, in 15 of the 31 patients BM samples were still available and were reanalysed at the Department of Pathology at the University Hospital of Graz, using nested PCR. Secondary, PubMed database was searched for relevant literature. Results: Our study did not show BM involvement at diagnosis in any of our 31 ES patients, neither morphologically, nor immunohistochemically, not even in the 5 patients with metastatic disease at diagnosis. The nested PCR results were also negative in all of our 15 retested patients. 15 relevant studies, showing different results, were found and summarized. Conclusion: According to our results and due to the previous findings of Kopp et al. we would, like Anderson and Valvi et al., also suggest the elimination of BMAB in the initial staging process of newly diagnosed paediatric and young adult ES patients.