Primary bone lymphoma: A retrospective analysis

Horsman, Janet; Thomas, Joel; Hough, Rachael; Hancock, Barry W.

doi:10.3892/ijo.28.6.1571

Cited by 42 publications

(65 citation statements)

References 18 publications

(39 reference statements)

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“…Most studies had small patient numbers retrospectively collected over a long timespan, resulting in a heterogeneous group of patients with different staging methods and treatment approaches [3,5,6,8,9,13,15,16]. Any study on this subject needs to span years or even decades; Ostrowski et al's report covers 75 years [11].…”

Section: Discussionmentioning

confidence: 99%

Malignant Lymphoma of Bone: A Review of 119 Patients

Demirçay

Hornicek

Mankin

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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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.

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Section: Discussionmentioning

confidence: 99%

Malignant Lymphoma of Bone: A Review of 119 Patients

Demirçay

Hornicek

Mankin

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Other authors report a similar prevalence, with DLBCL accounting for 73 % to >90 % [4-6, 12, 13, 16, 17]. Pathological fractures are reported in 10-21 % of patients [4,5,12,16], but a rate of 43 % was found in one series [9]. In our series, 28.6 % of patients suffered a pathological fracture.…”

Section: Discussionmentioning

confidence: 45%

“…1 A 23-year-old woman with primary bone lymphoma affecting the right proximal humerus: a coronal magnetic resonance imaging (MRI) view at presentation; b coronal MRI after chemotherapy and radiotherapy; c X-ray after chemotherapy and radiotherapy; d resection and reconstruction with prosthesis were performed Fig. 2 A 54-year-old man with primary bone lymphoma affecting the right tibia: a magnetic resonance imaging (MRI); b a few days after biopsy, a pathological fracture occurred; c before beginning chemotherapy and radiotherapy, the fracture was fixed with a plate without curettage of the involved bone; d fracture completely healed and the patient was disease free at 78 months Age seems to be an important factor in our series, as outlined previously by different authors [6,7,9,11,12,16], with younger age accounting for a better prognosis; however, in our series, there was only a trend for a better survival in younger patients, which did not reach statistical significance. The only positive prognostic factor found in our series was achievement of complete remission after primary treatment.…”

Section: Discussionmentioning

confidence: 63%

“…Little is reported about surgical procedures, even if surgery does, in some cases, become necessary for fractures or impending fractures. An incidence of orthopaedic surgical procedures other than biopsy, ranging from 13.8 % to 26 % [7][8][9][10] or even 47 % [5], is reported, but most papers either do not mention incidence or type of surgery [4,6,[11][12][13][14][15] or report incomplete data about the surgery performed [16,17]. Therefore, we decided to review our series in a single-centre, consecutive series of patients affected by primary bone lymphoma with the aim of: (1) evaluating incidence of surgery , (2) examining type of surgery and its combination with adjuvant treatment and (3) evaluating whether surgery should precede or follow radiotherapy and chemotherapy treatment.…”

Section: Introductionmentioning

confidence: 99%

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Primary lymphoma of bone: outcome and role of surgery

Scoccianti

Rigacci

Puccini

et al. 2013

International Orthopaedics (SICOT)

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Purpose Primary bone lymphoma is a rare disease. Little is reported about surgical procedures in these patients. We evaluated a single-centre consecutive series of 21 patients for results, prognostic factors and surgical treatment. Methods Patient ages ranged from 19 to 82 years. The most frequently affected site was the spine (six cases), followed by the ileum, femur and mandible (three cases each). Four patients were treated with chemotherapy and 17 with chemotherapy and radiation therapy. Six patients were affected by a pathological fracture. Surgery was performed in four patients (19 %), in two cases before chemotherapy, in one case during chemotherapy and in one case after chemotherapy and radiotherapy. Five patients died within the range of three to 36 months after diagnosis. Average follow-up of the remaining patients was 62.8 (19-145) months. Results Overall survival was 74.2 % at five years. The only positive prognostic factor was complete remission after chemotherapy. A trend for better survival was present for International Prognostic Index (IPI) score (P =0.051), under 40 years of age (P =0.10) and abnormal lactate dehydrogenase (LDH) values (P =0.10), but it did not reach statistical significance. Conclusions Surgical treatment should be aimed at restoring function and eliminating pain while minimising delays in the chemotherapy schedule. When feasible, postponing surgery until after chemotherapy is advisable.

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“…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). Considering these factors, the case reported in the present study may have a poor prognosis.…”

Section: Discussionmentioning

confidence: 89%

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

Tong

Zhang

et al. 2015

Oncology Letters

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Abstract. Primary bone lymphoma (PBL) is a rare disease, accounting for >1% of all cases of malignant lymphoma. Diffuse large B-cell lymphoma (DLBCL) is the most common histological type of PBL. The present study reported the case of a 68-year-old male with primary bone DLBCL, originally occurred in the sternum, which is a rare form of presentation. Computed tomography (CT), magnetic resonance imaging and bone emission CT were performed, followed by immunohistochemical analysis of a biopsy specimen, and the results were used to establish the diagnosis. At the time of diagnosis, no osseous involvement was observed. The clinical, radiological and histological features of PBL can mimic other medical conditions, thereby making the diagnosis difficult, and frequently leading to delays in treatment. The present study investigated the clinical features, management and prognosis of PBL, and reviewed previous relevant cases.

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Primary bone lymphoma: A retrospective analysis

Cited by 42 publications

References 18 publications

Malignant Lymphoma of Bone: A Review of 119 Patients

Malignant Lymphoma of Bone: A Review of 119 Patients

Primary lymphoma of bone: outcome and role of surgery

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

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