Journal of Clinical Oncology, Vol 16, 1707-1711, Copyright © 1998 by American Society of Clinical Oncology
Presence of tumor cells in bone marrow but not in blood is associated with adverse prognosis in patients with Ewing's tumor. Societe Francaise d'Oncologie Pediatrique
C Fagnou, J Michon, M Peter, A Bernoux, O Oberlin, JM Zucker, H Magdelenat and O Delattre
Departement d'Oncologie Pediatrique, Institut Curie, Paris, France.
PURPOSE: Gene fusions that result from the chromosome translocations
observed in Ewing's tumor (ET) provide tumor-specific markers that can be
used to detect the presence of tumor cells in peripheral blood (PB), bone
marrow (BM), and stem cell collection (SCC). These markers were used to
evaluate, at diagnosis, a series of 67 ET patients. PATIENTS AND METHODS:
RNA was extracted from nucleated cells from PB and BM and a nested
reverse-transcriptase polymerase chain reaction (RT-PCR) was performed to
search for EWS-FLI-1 or EWS-ERG fusion transcripts that resulted from the
t(11;22) or t(21;22) translocations, respectively. RESULTS: At diagnosis,
16 of 62 (26%) patients had circulating tumor cells. This was not
correlated with any clinical parameter. In contrast, Ewing's cells were
detected by RT-PCR in BM in 14 of 43 (33%) patients and were associated
with the presence of clinically detectable metastases and a statistically
significant unfavorable outcome in univariate analysis. There was no
correlation between the RT-PCR results in PB and in BM. CONCLUSION: These
results suggested that the monitoring of BM but not of PB by RT-PCR might
constitute an important criterion for the staging, at diagnosis, of
patients with ET. Further studies should appreciate the relationship or
independence of this marker toward other classical prognostic factors in
ET, particularly to the presence of clinically detectable metastases.
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