Laboratory Work-Up of Chronic B-Cell Lymphoid Malignancies – A Value-Based Approach

Abstract

The aim of study was to summarize recent developments in laboratory work-up of lymphomas and discuss their clinical relevance. Diagnosis of lymphoma requires tissue biopsy with adequate work-up by pathologists. Recent developments in laboratory testing have raised the bar  for establishing the diagnosis: more and more testing seems to be required, while the lines between research and clinical practice are being blurred. Academic medical practice is designed to push boundaries and test new hypotheses, which eventually result in improved patient care. Ability to (relatively) cheaply screen for multiple genomic abnormalities using new technologies is luring. Often, however, no change in patient management is pursued based on these results. It is therefore useful to review which testing is truly necessary from the patient’s point of view.

Conclusions. The laboratory work-up of lymphomas in a regular clinical practice requires relatively few tests. Many new tests have prognostic value, but do not necessarily contribute to the patient management.