Bone marrow changes in neuroblastoma

Bone marrow examination at the time of diagnosis of neuroblastoma was performed in 48 new cases prior to instituting therapy. Bone marrow involvement by neuroblastoma was present in 20 patients (approximately 42%). In this study the trephine biopsy was a more reliable technique than marrow aspiration in establishing the presence of metastatic disease, but in a single case the trephine biopsy was negative with metastatic cells present in the aspirate. Myelofibrosis secondary to metastatic neuroblastoma was a frequent finding, being the predominant feature in 6 cases. Bone marrow involvement by neuroblastoma was usually associated with the presence of a primary adrenal tumor and occurred only infrequently with extra-adrenal primary origin. Bone marrow involvement was usually present at the time of presentation in case where the primary tumor was located in the adrenal gland.