Bone marrow (BM) core biopsy was found to be valuable in the workup of 25% of patients with chronic myeloid leukemia (CML), according to a retrospective study published in Cancer. The biopsy helped facilitate identification of the disease phase and presence of myelofibrosis, the initial grade of which is associated with the disease stage and outcome after therapy.

CML is typically diagnosed through the identification of BCR/ABL1 in a patient’s peripheral blood. BM aspiration can aid in determining the disease phase and karyotype of the patient, but there has been controversy about the true utility of BM core biopsy in the workup of patients with CML.

The researchers examined 508 consecutive patients with CML who received BM aspiration and core biopsy to determine whether BM core biopsy added value to diagnostic workup for CML. BM core biopsy was categorized as essential, helpful, or noncontributory for each patient.

BM biopsy was found to be helpful or essential in 25% of patients (127/508). In addition, high-grade myelofibrosis was more frequent in patients with accelerated phase/blastic phase disease than in patients with chronic-phase disease.

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The researchers suggested using BM core biopsy for patients with AP/BP CML or who demonstrate other findings suggestive of progressive disease.

Reference

1. Juliana E. Hidalgo‐Lόpez, Rashmi Kanagal‐Shamanna, Andrés E. Quesada et al. Bone marrow core biopsy in 508 consecutive patients with chronic myeloid leukemia: Assessment of potential value [published online October 15, 2018]. Cancer. doi: 10.1002/cncr.31663