Bone marrow metastasis (BMM) from non-hematolymphoid cancers can resemble primary blood and lymphatic system disorders due to similar symptoms, according to a new retrospective study. Researchers examined records from the past decade at their institution to better understand the clinical and pathological features of BMM originating from non-hematopoietic tumors.
The study reviewed 54 cases diagnosed with BMM. The most frequent primary cancers that led to bone marrow metastases were prostatic adenocarcinoma (29.6%), breast carcinoma (25.9%), colorectal adenocarcinoma (5.5%), and lung carcinoma (5.5%). Patients commonly presented with anemia in 90.7% of cases, reticulocytosis in 80.5%, thrombocytopenia in 73.9%, bone pain in 55.5%, disseminated intravascular coagulation in 39.6%, leukoerythroblastosis in 35.3%, and leukopenia in 24%.
Morphological examination was sufficient to identify the metastatic tumors in most cases (96.3%). However, immunohistochemistry was needed for diagnosis when tumor features were subtle, accounting for about 2.7% of cases.
In nearly one-third of patients (29.6%), BMM was found before or at the same time as other metastatic sites, suggesting its potential role as an early indicator of cancer spread. The median interval between initial cancer diagnosis and detection of bone marrow involvement was 29 months.
Treatment after a BMM diagnosis led to significantly improved outcomes for patients: "Although patients who received anti-tumor treatment after BMM diagnosis showed significantly improved prognosis (P < 0.01), no significant differences were observed between those treated with immunotherapy versus chemotherapy and/or radiotherapy (P = 0.145)," the authors stated.
The study concludes that prostate and breast cancers are the most common sources of BMM, with anemia, reticulocytosis, and thrombocytopenia being key clinical signs. Anti-neoplastic therapy following a BMM diagnosis appears to extend survival regardless of the specific treatment approach used or type of underlying cancer.
