Determination of Marrow Involvement in Non-Hodgkin's Lymphoma by Immunocytochemical Studies

Abstract

Bone marrow involvement in non-Hodgkin's lymphoma (NHL) alone can raise the clinical stage from I and II (localized disease) to IV (advanced disease). Multiparameter assessment is thus required to detect early marrow involvement (positive marrow) besides the conventional morphologic evaluation of bone marrow biopsy and marrow aspirates. Determination of lymphocyte subsets in the marrow is considered useful if the phenotype of NHL is known. To prove this possibility, we have performed immunocytochemical studies on marrow aspirate smears to determine CD3+ T-cells and CD19+ B-cells by using the alkaline phosphatase-labeled streptavidin-biotin method in 8 cases of NHL with positive marrow (4 B-cell, 4 T-cell NHL), 11 cases of NHL with negative marrow (8 B-cell, 3 T-cell NHL), and 11 cases of controls including Hodgkin's disease (2), acute leukemia (4), SLE (1), anemia (1), inflammatory bowel disease (1), polycythemia vera (1), and Wegener's granulomatosis (1). CD3+ T-cells and CD19+ B-cells were enumerated by counting 500 nucleated marrow cells. The results showed that the mean CD3/CD19 ratios in B-cell NHL and T-cell NHL with positive marrow were 1.8 and 20.5, while those in B-cell NHL and T-cell NHL with negative marrow and in controls were 3.3, 3.1, and 2.6, respectively. Moreover, cytologic difference between CD3+ T-cells and CD19+ B-cells was observed in 1 case of B-cell NHL and 3 cases of T-cell NHL with positive marrow, while such a difference was absent in NHL with negative marrow and in controls except in 1 case of T-cell NHL with negative marrow. Therefore, immunocytochemical studies are helpful to determine marrow involvement in NHL.