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Answer 2
  1. Small cleaved cell lymphoma. Whenever lymphoma involves the bone marrow, there is a high risk that peripheral blood stem cells will also be contaminated by tumors. For large B-cell lymphoma, Hodgkin’s disease, anaplastic large cell lymphoma, and peripheral T-cell lymphoma, the incidence of bone marrow involvement ranges from 5% to 20%. Even in these histologic types of lymphoma, a bone marrow examination is necessary to rule out lymphomatous involvement prior to harvesting stem cells for purposes of transplantation. However, the incidence of bone marrow involvement in small cleaved cell lymphoma is dramatically higher; 60% to 70% of cases have involvement of the bone marrow on microscopic examination. Additionally, when the bone marrow does not appear to be involved in small cleaved cell lymphoma, about two thirds of cases have bone marrow involvement when assessed by molecular genetic studies looking for bcl-2 or heavy chain gene rearrangement.3

     Berinstein NL, Reis MD, Ngan BY, et al. Detection of occult lymphoma in the peripheral blood and bone marrow of patients with untreated early-stage and advanced-stage follicular lymphoma. J Clin Oncol 1993;11:1344-52.

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