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Limitations in the ability of NB84 to detect metastatic neuroblastoma cells in bone marrow
  1. S N Bomken1,
  2. K Redfern2,
  3. K M Wood3,
  4. M M Reid4,
  5. D A Tweddle5
  1. 1Department of Paediatric Oncology, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  2. 2University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne
  3. 3Department of Histopathology, Royal Victoria Infirmary
  4. 4Department of Haematology, Royal Victoria Infirmary
  5. 5Northern Institute for Cancer Research, Medical School, Newcastle upon Tyne
  1. Correspondence to:
    D A Tweddle
    Northern Institute for Cancer Research, Medical School, Framlington Place, Newcastle upon Tyne NE2 4HH, UK;D.A.Tweddle{at}


Background: The accurate assessment of metastases is an essential component of the staging process for children with neuroblastoma.

Aims: To study the sensitivity of the immunohistochemical marker neuroblastoma 84 (NB84) for the detection of bone marrow infiltrates in children with stage 4 neuroblastoma.

Methods: Primary tumour specimens, bone marrow trephine biopsy specimens and lymph node metastases, taken from children with neuroblastoma that had metastasised to bone marrow, were assessed with a panel of commonly used immunohistochemical markers for neuroblastoma. A comparison was drawn between the sensitivity of the marker NB84 for primary tumours and for bone marrow metastases.

Results: NB84 immunolabelled all pre-chemotherapy and post-chemotherapy (n = 24) paired primary tumour specimens, as well as each of a further 20, unpaired, pre-chemotherapy primary tumour specimens. It also labelled all (n = 4) lymph node metastases. Immunolabelling of bone marrow trephine biopsy specimens (21/33) was less sensitive. Of 16 primary tumour specimens with a paired bone marrow trephine biopsy specimen, all immunostained positive, whereas only 62.5% of bone marrow biopsy specimens immunostained positive for NB84. The number of bone marrow biopsy specimens immunostaining for NB84 was significantly lower than the number of paired primary tumour specimens (p = 0.041).

Conclusions: NB84 remains a useful marker for the diagnosis of neuroblastoma in primary tumour specimens, but not for neuroblastoma that has metastasised to bone marrow.

  • H&E, haematoxylin and eosin
  • NB84, neuroblastoma 84
  • PGP9.5, protein gene product 9.5

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  • Published Online First 24 March 2006

  • Competing interests: None.