An aggressive bone marrow evaluation including immunocytology with GD2 for

CHANTADA GL, ROSSI J, CASCO F, FANDIÑO A, SCOPINARO M, DE DÁVILA MT, ABRAMSON DH.

JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY

Año: 2006 p. 369 - 373

1077-4114

There is general agreement that bone marrow (BM) examination for staging inpatients with retinoblastoma should be limited to cases with advanced disease.However, there are limited data about the yield of sampling multiple sites withaspirations and biopsies and immunocytology. Our policy for BM examinationincluded: 2 aspirates and 2 biopsies at the posterior iliac crest scheduled only for cases with postlaminar optic nerve extension (n=56), scleral invasion (n=10) or orbital (n=5) or metastatic disease at diagnosis (n=7) or at extraocularrelapse (n=18). Immunocytology with the antibodies 3A7 or 3F8 for the gangliosideGD2 was performed. From 1/1994 to 3/2005, 277 newly diagnosed patients and 5 atextraocular relapse were included. BM invasion was not found in any of the 66patients enucleated with disease confined to the globe, but was found in 11/27 ofthose with overt extraocular disease. There were 2/11 cases with at least 1negative aspirate with positive biopsy and/or immunocytology for GD2. GD2positivity was found in 9/9 cases. A more aggressive BM evaluation has a lowyield in enucleated patients with high-risk features but disease limited to theglobe. However, in cases with overt extraocular dissemination, the use of BMbiopsy and immunocytology for GD2 allowed for the detection of cases that wouldhave been missed by aspirations alone. GD2 was intensively expressed and it mayalso be used to monitor disease response and the presence of minimal residualdisease.