Presence of differentiating neuroblasts in bone marrow is a favorable prognostic factor for bone marrow metastatic neuroblastoma at diagnosis

Ann Lab Med. 2013 Mar;33(2):89-96. doi: 10.3343/alm.2013.33.2.89. Epub 2013 Feb 21.

Abstract

Background: The prognostic impact of the presence of differentiating neuroblasts in bone marrow (BM) remains unclear in BM metastatic neuroblastoma (NB). We aimed to identify the prognostic impact of differentiating neuroblasts in BM at diagnosis and after chemotherapy.

Methods: A total of 51 patients diagnosed with BM metastatic NB at Asan Medical Center between January 1990 and July 2005 were enrolled. BM histology and laboratory data along with overall survival (OS) were compared with regard to the differentiation status of neuroblasts in BM at diagnosis and after chemotherapy.

Results: Among the 51 patients, 13 (25.5%) exhibited differentiating neuroblasts in BM at diagnosis and 17/51 (33.3%) exhibited them after chemotherapy. The only significant difference among patient groups was the improved OS in patients with differentiated neuroblasts in BM at diagnosis (P=0.021). In contrast, the differentiation status of neuroblasts in BM after chemotherapy did not affect OS (P=0.852).

Conclusions: Our study is the first report describing the presence of differentiating neuroblasts in BM. The presence of differentiating neuroblasts in BM at diagnosis may be a favorable prognostic factor for patients with BM metastatic NB; however, the same phenomenon after chemotherapy is irrelevant to prognosis.

Keywords: Bone marrow; Differentiating neuroblasts; Metastasis; Neuroblastoma; Prognosis.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow / pathology*
  • Bone Marrow Cells / cytology*
  • Bone Marrow Neoplasms / diagnosis*
  • Bone Marrow Neoplasms / secondary
  • Cell Differentiation
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Karyotyping
  • Male
  • Neoplasm Grading
  • Neuroblastoma / diagnosis*
  • Neuroblastoma / drug therapy
  • Neuroblastoma / pathology
  • Prognosis
  • Survival Analysis
  • Young Adult