Kemik İliği Biyopsisi ile İlk Tanı Alan Solid Tümörlerde Klinik ve Laboratuvar Özellikler

Abstract

Kayaalp, D. Clinical and Laboratory Features of Solid Tumors Initially Diagnosed by Bone Marrow Biopsy. Hacettepe University Faculty of Medicine, Department of Internal Medicine, Thesis in Internal Medicine Specialty, Ankara, 2026. Objective: Bone marrow metastasis is an uncommon but clinically significant manifestation of advanced solid malignancies and is associated with poor prognosis. This study aimed to evaluate the clinical, hematological, and biochemical characteristics of patients with solid tumors initially diagnosed by bone marrow biopsy and to investigate their association with overall survival. Materials and Methods: A total of 30 patients with bone marrow metastasis from solid tumors were retrospectively analyzed. Demographic data, primary tumor types, hematological and biochemical findings, peripheral blood smear results, and survival data were recorded. Overall survival was analyzed using the Kaplan–Meier method. Survival comparisons between groups were performed using the log-rank test. Cox proportional hazards regression analysis was conducted for selected variables. Results: The median age at diagnosis was 57.5 years, and 73.3% of patients were male. The most common primary tumors were lung (20%), breast (16.7%), gastric (13.3%), and prostate cancer (13.3%); in 23.3% of patients, the primary tumor could not be identified. Anemia and thrombocytopenia were each observed in 75% of patients, while bicytopenia was present in 60.7%. Among patients with available peripheral smear data, leukoerythroblastic changes were observed in 50%, and features of microangiopathic hemolytic anemia in 25%. Biochemical abnormalities were frequent, including elevated LDH (80.8%), ALP (85.7%), CRP (72%), and ESR (65.4%), while hypoalbuminemia was detected in 28.6% of patients. The median overall survival was 64 days (95% CI: 43.8–84.2 days). No statistically significant association was found between hematological or biochemical parameters and overall survival. Conclusion: Patients with bone marrow metastasis from solid tumors have a markedly poor prognosis with a short median survival. Primary tumors are frequently unidentified, and anemia and thrombocytopenia are the most common hematological abnormalities. Leukoerythroblastosis may serve as an important peripheral blood finding suggestive of bone marrow infiltration. However, conventional hematological and biochemical parameters alone appear to have limited prognostic value in predicting survival. Keywords: Bone marrow metastasis, solid tumors, myelophthisis, thrombocytopenia, anemia, leukoerythroblastosis