Introduction: Bone marrow involvement is not very common in Hodgkin Lymphoma (HL) and when present has an implication on the treatment strategies and prognosis of the patient. This study evaluates the various bone marrow changes seen in Hodgkins Lymphoma. Methods: This is a one year retrospective study carried out in the cilinical laboratory of Kasturba Hospital, Manipal, India. All the patients diagnosed as HL on lymph node biopsy in whom bone marrow aspirate and biopsy were done were included in the study. Results: A total of 24 patients of HL were included in the study. Bone marrow infiltration was seen in only 2
patients (8.3%). 4 cases (16.6%) showed Hodgkin associated changes in the bone marrow whereas remaining 18 patients (75%) did not show any changes in the bone marrow. The cases with infiltration showed presence of mononuclear variant of Reed Sternberg cells with increased eosinophils and lymphocytes. Hodgkin associated changes included increased eosinophils, monocytes and histiocytes, dyspoeticmegakaryocytes, presence of atypical lymphocytes and increased activated histiocytes but absence of RS cells or its variants. 18 patients received the ABVD chemotherapy regimen whereas 6 patients did not receive treatment in our hospital. Out of the 18 patients
only one patient relapsed in one year follow up. Conclusion: The incidenceof BMI is rare in HL as compared to Non Hodgkin lymphoma. The BMI can be in the form of frank infiltration or non infiltrative Hodgkin associated changes. The relationship between Hodgkin associated changesand prognosis of the disease is not yet clearly understood. However bone marrow examination is a must in all cases of HL to aid in appropriate staging and to decide on treatment modifications required.

Keywords: Hodgkin lymphoma; Bone marrow; Reed Sternberg cell; Histiocytes.