VALUE OF SEQUENTIAL BONE-MARROW BIOPSY AND LAPAROTOMY AND SPLENECTOMY IN A SERIES OF 200 CONSECUTIVE UNTREATED PATIENTS WITH NON-HODGKINS LYMPHOMA

The information derived from sequential routine bone marrow biopsies and exploratory laparotomy with splenectomy in 200 consecutive untreated protocol patients with malignant lymphomata other than Hodgkin's disease is reviewed. Of 114 patients with nodular lymphomata, 64% had a change of stage after these diagnostic procedures, almost all to more advanced stages, usually as a result of bone marrow biopsy. Of 86 patients with diffuse lymphomata, 29% changed stage, one-third of them to a lower stage. The correlation of pathological stages to clinical stages is presented for the major subgroups of the Rappaport classification. Bone marrow biopsy demonstrates that 76% of patients with nodular lymphocytic poorly differentiated (NLPD) lymphoma have disseminated disease at the time of diagnosis. In only 13% of patients with diffuse histiocytic (DH) lymphoma is the bone marrow involved at the time of diagnosis. The different natural history of these two major histological subgroups is emphasized. © 1979.