[Clinico-pathological characteristics, response to therapy and survival of patients with bone marrow infiltration by Hodgkin's lymphoma].

In a group of 246 patients with Hodgkin's lymphoma we found bone-marrow involvement in 25 patients (10.2%). Clinico-pathological characteristics, response to therapy and survival of those patients were compared with control group of 25 patients in clinical stage ill. Most of the patients with bone marrow involvement were older males, with "B" symptoms, bulky disease, peripheral blood cytopenias and elevated serum alkaline phosphatase. Bone marrow was diffusely infiltrated by Hodgkin's lymphoma in 17 and focally in 8 patients. Marrow fibrosis was noted in 19 patients. Histological type of the disease in affected lymph nodes was not a predictive factor for marrow involvement. Intensive combined chemotherapy was given to 21 patients, and 38% of them achieved prolonged complete remission. The four-year overall survival of 21 treated patients was significantly shorter than in the control group (31.3% vs. 75%, p=0.002). Our study showed that marrow involvement by Hodgkin's lymphoma indicated unfavourable prognosis, particularly in patients with marked splenomegaly and hepatomegaly and elevated serum alkaline phosphatase.