Immunomagnetic detection of micrometastatic cells in bone marrow of uveal melanoma patients: a paradox

Acta Ophthalmol. 2015 Feb;93(1):59-66. doi: 10.1111/aos.12462.


Purpose: Our objective was to study survival rates with the bone marrow (BM) results in a cohort of uveal melanoma patients with long follow-up.

Methods: Mononuclear cell fractions isolated from BM were examined for tumour cells using our immunomagnetic separation (IMS) method. The patients were classified as BM positive or BM negative. Clinical follow-up, histopathological findings, vital status and cause of death were registered.

Results: The study included 328 consecutive patients with uveal melanoma from 1997 to 2006. Tumour cells were found in BM samples in 29% (95% CI, 25-34) at enrolment (96 cases). After a minimum follow-up time of 6 years, 156 (48%) (95% CI, 42-53) melanoma patients had died. The causes were as follows: melanoma metastases 92 (59%), another cancer 20 (13%) and non-cancer 44 (28%). Nine patients were still living with melanoma metastases. Until the latest work-up, 101(31%) (95% CI, 26-36) patients had developed melanoma metastases. Cyto- or histopathological verification of the metastatic lesions was obtained in 85 cases (84%). In the group with melanoma metastases, 28 tested BM positive at study entry (28%) (95% CI, 19-38). In total, 39 of 101 with metastases tested positive at least once after a maximum of three tests (39%) (95% CI, 29-49). The overall median survival from the first BM test was shorter for the BM negative patients (9.5 years) compared with the BM positive (14.4 years), p = 0.02, log rank test.

Conclusion: Ocular melanoma cells detected in BM seem to have a positive prognostic impact on survival in contrast to our original hypothesis.

Keywords: immunomagnetic detection; micrometastasis in bone marrow; outcome; survival; uveal melanoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Marrow Cells / pathology*
  • Bone Marrow Neoplasms / mortality
  • Bone Marrow Neoplasms / secondary*
  • Cause of Death
  • Child
  • Female
  • Humans
  • Immunomagnetic Separation*
  • Male
  • Melanoma / mortality
  • Melanoma / secondary*
  • Middle Aged
  • Neoplastic Cells, Circulating / pathology*
  • Norway / epidemiology
  • Prospective Studies
  • Survival Rate
  • Uveal Neoplasms / pathology*