Disseminated Tumor Cells

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Regular Member

Date Joined Aug 2008
Total Posts : 328
   Posted 2/10/2009 1:53 PM (GMT -6)   
Interesting article ...wondering if I should I get my bone marrow tested...



Disseminated Tumor Cells in Prostate Cancer Patients after Radical Prostatectomy and without Evidence of Disease Predicts Biochemical Recurrence

Todd M. Morgan1, Paul H. Lange1, Michael P. Porter1,2, Daniel W. Lin1,2, William J. Ellis1, Ian S. Gallaher1 and Robert L. Vessella1,2

Authors' Affiliations: 1 Department of Urology, University of Washington School of Medicine, and 2 Puget Sound VA Health Care System, Seattle, Washington

Requests for reprints: Todd M. Morgan, Department of Urology, 1959 NE Pacific, BB-1115, Box 356510, Seattle, WA 98195. Phone: 206-540-8990; Fax: 206-543-1146; E-mail: tmorgan2@u.washington.edu <script type=text/javascript><!-- var u = "tmorgan2", d = "u.washington.edu"; document.getElementById("em0").innerHTML = '' + u + '@' + d + '<\/a>'//--></script> .

<!-- ABS -->Purpose: Men with apparently localized prostate cancer often relapse years after radical prostatectomy. We sought to determine if epithelial-like cells identified from bone marrow in patients after radical prostatectomy, commonly called disseminated tumor cells (DTC), were associated with biochemical recurrence.

Experimental Design: We obtained bone marrow aspirates from 569 men prior to radical prostatectomy and from 34 healthy men with prostate-specific antigens <2.5 ng/mL to establish a comparison group. Additionally, an analytic cohort consisting of 98 patients with no evidence of disease (NED) after radical prostatectomy was established to evaluate the relationship between DTC and biochemical recurrence. Epithelial cells in the bone marrow were detected by magnetic bead enrichment with antibodies to CD45 and CD61 (negative selection) followed by antibodies to human epithelial antigen (positive selection) and confirmation with FITC-labeled anti-BerEP4 antibody.

Results: DTC were present in 72% (408 of 569) of patients prior to radical prostatectomy. There was no correlation with pathologic stage, Gleason grade, or preoperative prostate-specific antigens. Three of 34 controls (8.8%) had DTC present. In patients with NED after radical prostatectomy, DTC were present in 56 of 98 (57%). DTC were detected in 12 of 14 (86%) NED patients after radical prostatectomy who subsequently suffered biochemical recurrence. The presence of DTC in NED patients was an independent predictor of recurrence (hazard ratio 6.9; 95% confidence interval, 1.03-45.9).

Conclusions: Approximately 70% of men undergoing radical prostatectomy had DTC detected in their bone marrow prior to surgery, suggesting that these cells escape early in the disease. Although preoperative DTC status does not correlate with pathologic risk factors, persistence of DTC after radical prostatectomy in NED patients was an independent predictor of recurrence.

Age Dx 37, 7/2008
First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008
Biopsy : 6 out 12 Postive all on right side, Gleason 7 (3+4).
Bone Scan/CAT Scan: Clear 7/2008
Cystoscope: Normal 7/2008
Prostate MRI: Normal 7/2008
Da Vinci Surgery 7/2008
PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
First PostOp PSA 9/2008: <0.01
2nd PSA 12/2008: <0.1 (Different Lab then 1st)
3rd PSA 3/2009

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 2/10/2009 2:04 PM (GMT -6)   
Ever had bone marrow aspiration? It will make you think twice about getting a second one.
You are beating back cancer, so hold your head up with dignity
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 2/10/2009 2:21 PM (GMT -6)   
Ouchie..bone marrow aspiration is not something I'd want to experience. It isn't the stick that hurt so much its the aspiration of marrow that smarts. If it were the only way to diagnose something then fine..do it. To do it for any other reason, well, God Bless those study volunteers!
I've read part of this study and the potential use of modified citrus pectin. Thanks for the abstract! Always appreciate good reading.

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