Detection and clinical significance of disseminated tumour cells at diagnosis in bone marrow of children with localised rhabdomyosarcoma

Heather P. McDowell, Alberto Donfrancesco, Giuseppe M. Milano, Anna Clerico, Olga Mannarino, Pierluigi Altavista, Renata Boldrini, Raffaele Cozza, Alessandro Inserra, Carlo Dominici

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9 Citations (Scopus)


Identification of patients with a poor prognosis for non-metastatic rhabdomyosarcoma (RMS) remains a clinical challenge. Prospective analysis for the presence of disseminated RMS cells in bone marrow at diagnosis, using immunocytochemistry, with MyoD1 and myogenin as markers, was carried out. Thirty-seven patients treated on RMS88 and RMS96 Italian protocols underwent staging investigations, and in addition marrow examination for occult tumour cells. All patients had negative marrow involvement using cytomorphology, but 10/37 were positive with immunostaining. With a median follow-up of 46 months (range, 12-115), 7 patients had died and 30 were disease-free. Overall survival probability was 92% in patients with no occult marrow infiltration, 47% with occult marrow infiltration (P = 0.001); event-free survival probability was 89% in the former and 50% in the latter (P = 0.01). Disseminated tumour cells are indicative of disease spread and are significantly linked to recurrence at distant sites and poorer outcome. Marrow examination at diagnosis using immunocytochemistry may be an additional tool to modulate treatment. © 2005 Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)2288 - 2296
Number of pages9
JournalEuropean Journal of Cancer
Issue number15
Publication statusPublished - Oct 2005
Externally publishedYes


All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Hematology
  • Oncology

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