Background:
the study was undertaken to determine whether the sex, age distribution, tumor origin, hematologic and biochemical data, as well as the predictive factors of malignant tumors which metastatized to the bone marrow (BM) could be used as
diagnostic
criteria.
Methods:
The hematologic and biochemical data of 59 patients (81 cases) who had undergone BM aspiration and biopsy, and diagnosed as having BM metastases of a malignant tumor at Hanyang University Hospital between January, 1984 and December, 1993 were
reviewed. The results were compared with other studies performed both here and abroad, and were adapted to the previously existing predictive factors for BM metastases of malignant tumors.
Results:
The sex ratio of the BM metastases of malignant tumors was 2:1, and showed the highest incidence in patients in their sixties. The origin of the primary tumor in decreasing order was adenocarcinoma of the gastrointestinal tract, followed by
tumors
of unknown origin and neuroblastoma. The incidence of thrombocytopenia and the proportion of segmented neutrophils was low, showing a difference with previous reports, but the incidence of anemia and leukoerythroblastosis did not show a
significant
difference. Biochemically, there was a clear increase in the lactic dehydrogenase (LDH) level and an increase of alkaline phosphatase level (ALP) in 50%. These factors when applied to the diagnostic criteria of malignant tumors that metastatized
to
the
BM, showed a low sensitivity of 57%. BM metastases were found in 90% and 94% of BM aspirations and biopsies, respectively, showing no significant difference between the two.
Conclusion:
The predictive factors that have been used for BM metastases of malignant tumors show low sensitivitive. Therefore, it is recommended that a BM aspiration and biopsy be performed whenever a malignant tumor is detected irrespective of the
hemalotogic
or biochemical findings.
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