When is a bone marrow biopsy indicated in the up-front evaluation of an AYA patient with Ewing sarcoma?

In general, I would not recommend a different approach to the initial staging evaluations for an AYA with a new diagnosis of Ewing sarcoma vs a younger child or an older adult.

Although the standard approach that is most widely accepted would be to perform a bone marrow evaluation for all patients with newly diagnosed Ewing sarcoma, there is recent data in the form of a meta-analysis that provides support for the elimination of a bone marrow in the specific circumstance of negative staging studi...

Bone marrow aspirate/biopsy (BMA/B) is routinely performed in the upfront staging of newly diagnosed patients with Ewing sarcoma (EWS) and has been a requirement in the most recent EWS clinical trials through the Children's Oncology Group which included patients up to age 50. At this time, we have no evidence to suggest that the initial staging process should be different for AYA patients vs children even though the current NCCN guidelines suggest that MRI spine/pelvis could be substituted for B...