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Interestingly, the CD44+CD24-/low CD44+CD24-/lowng cell phenotype [ 84] was observed in a significant number of bone marrow DTcellsing triphenotypeing by immunocytochemistry [ 84].
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Since blood is more easily obtained than bone marrow, an important question is whether peripheral blood CTCs can be used as surrogate markers for bone marrow DTCs.
Using single cell comparative genomic hybridization, it has been shown that bone marrow DTCs are genetically heterogeneous and display fewer genetic aberrations than primary tumor cells [ 97- 99].
During this time, bone marrow DTCs (Janni et al, 2011) as well as CTCs derived from the DTCs (Meng et al, 2004) may be found in these patients.
In multivariate analysis, the presence of bone marrow DTCs predicted for significantly higher risk of death from BC [ 4].
Although the DTC detection rate was very low, bone marrow DTCs still significantly predicted decreased overall survival [ 47].
According to clinical studies on bone marrow DTCs, 50%to70%0% of patients with detectable DTCs will not develop metastases, although even patients without DTCs may relapse and die of BC [ 4].
This is in contrast with only small blood and bone marrow volume used to assess CTC and DTCs in patients.
At the time of bone marrow biopsy, DTCs had round shapes when examined fresh and after capture by the MagSweeper.
Disseminated tumour cells (DTC) can be detected in bone marrow of cancer patients using a pan-cytokeratin (CK) antibody, as reviewed by K Pantel (Hamburg, Germany).
Bone marrow fibrosis was graded using European consensus guidelines20.
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