Malignant Lymphoma of Bone: A Review of 119 Patients

Abstract

Background Lymphoma of bone is uncommon. As a result of this, many aspects of primary lymphoma of bone (PLB) are controversial: the definition, treatment strategies, response criteria, and prognostic factors. Questions/purposes We sought to determine the following in an analysis from a single center over a four-decade period: (1) 5-year disease-free survival of patients with PLB as well as those with systemic lymphoma with bone involvement; and (2) whether prognostic factors (sex, site of tumor, age) were associated with 5-year survival. Methods A total of 119 patients with lymphoma involving the musculoskeletal system were retrospectively evaluated. Among these, 94 patients who had a minimum followup of 6 months (mean, 67 months; range, 6 months to 34 years) were further analyzed for the skeletal site of involvement, the orthopaedic intervention(s) needed, and survival. The overall median age was 45 years (range, 7-87 years). The female-to-male ratio was 1:1.53. There were 70 (65 unifocal, five multifocal) patients with PLB. The femur was the most frequent site involved. Appendicular skeleton involvement was substantially higher in patients with PLB. Thirty-four (36%) patients had at least one surgical intervention. Fourteen patients (41%) needed more than one major surgical intervention. Results The disease-free 5-year survival for patients with PLB was 81% and for the patients with systemic lymphoma with bone involvement, it was 44%. The diseasefree 5-year survival of the patients with PLB younger than 60 years old and 60 years old or older was 90% and 62%, respectively. Age was the only prognostic factor on survival of patients with PLB. Conclusions Orthopaedic intervention was usually needed for pathologic fractures, avascular necrosis, spinal cord compression, or for the lesions of the weightbearing bones compromising stability or joint motion. The potential for long-term survival suggests the use of implants and techniques that have the best chance of long-term success.

Primary sternum diffuse large B-cell lymphoma: A case report and review of the literature

“…Radiotherapy was established as the standard treatment in earlier years (19,20). However, with the development of highly effective chemotherapy regimens and particularly the advent of novel agents, such as the anti-CD20 monoclonal antibody rituximab, the role of radiotherapy has been increasingly questioned by certain researchers (2,(25)(26)(27).…”

“…The five-year OS rates vary greatly, as demonstrated in clinical trials and retrospective population-based studies (2,9,20,28,29,51,53). In addition, various studies have suggested different prognostic factors, including age (29,50,51,56), gender (10), stage (2), LDH levels (10), lesion range (51) and IPI score (28,56).…”

Rheumatische Krankheitserscheinungen bei hämatologischen Neoplasien

“…Rahmen der Autoimmunerkrankung führt zu erhöhtem Lymphomrisiko [10,9], p < 0,0001). In ähnlichen Untersuchungen wurden auch noch die vaskulitische Purpura, die Lymphopenie und der Nachweis von Kryoglobulinen als Risikofaktoren identifiziert [35].…”

“…Bei anderen Non-Hodgkin-Lymphomen (NHL) und auch beim Morbus Hodgkin wurde in Einzelberichten neben Arthralgien und Myalgien auch eine eosinophile Fasziitis, eine Arthritis oder Gelenkinfiltration mit Tumorzellen beschrieben [9,31]. Etwa ein Drittel der Arthritiden lag dabei als Polyarthritis vor, und bei ca.…”

“…Etwa ein Drittel der Arthritiden lag dabei als Polyarthritis vor, und bei ca. einem Drittel wurde eine Monoarthritis beschrieben [9].…”