Marrow contamination: Detection and significance

Detection of malignant cells in the bone marrow is important for accurate staging of patients. The results of marrow evaluations may have prognostic and therapeutic implications, particularly for patients who are receiving marrow-supported high-dose therapy. This chapter discusses several current methods employed to detect tumor cells in bone marrow. It reviews the clinical significance of the malignant cells identified in the marrow using the various methods. The hematopoietic cell autograft contamination with malignant cells has stimulated the development of several strategies to eradicate malignant cells from marrow and more recently peripheral blood progenitor cells fractions. With flow cytometry, the marrow/tumor cell sample is pre-incubated with specific fluorochrome-labeled monoclonal antibodies. The single cells are then suspended in fluid and passed though a beam of laser light surrounded by an array of detectors. The detectors are able to measure the fight scattering properties of the cells, as well as the fluorescence that is emitted.