Primary Bone Lymphoma — Treatment and Outcome

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

“…For instance, in the IELSG-14 study, the addition of radiotherapy following chemotherapy, or the use of larger radiation fields and doses, were not associated with an improved outcome in patients treated with chemoradiotherapy (9). Although previous studies have obtained contradicting results, chemoradiotherapy is likely to be superior to single modality therapy, which may be advantageous for localized unifocal bulky sites of disease, which allows a shorter chemotherapy course (1,30,35), or for multifocal disease in relapsing cases (36). Anthracycline-containing chemotherapy has become the standard therapy of DLBCL, while numerous studies have demonstrated increased long term remission rates with the incorporation of rituximab (33,(37)(38)(39)(40)(41)(42).…”

“…Another issue is to determine whether surgery is required. At present, due to the development of effective oncological treatments, surgery is not routinely used in the management of PBL, with the exception of the initial biopsy performed to establish a diagnosis and the treatment of PFs (1,22). A recent study reported that, although PFs occurred, the initial surgical stabilization of the PFs did not change the therapeutic outcome, and patients receiving chemotherapy prior to irradiation of the fractured bone exhibited an improved outcome (53).…”

“…Finally, the transformation of treatment mode was inevitable, which depends on the stage. No conclusive view exists on the response of PBL to various radiotherapy doses, while the majority of studies used doses that are commonly used to treat NHL (35-45 Gy in 1.8-2 Gy fractions) (1,30,31). However, a randomized trial conducted in the British population revealed that radiotherapy at a dose of 30 Gy following chemotherapy was adequate for the treatment of NHL, including extra-nodal sites (60), while higher doses may be reserved for cases with a suboptimal response to chemotherapy.…”

“…Primary bone lymphoma (PBL) is an uncommon, malignant, neoplastic disorder of the skeleton, which accounts for 5-7% of primary bone tumors, 4-5% of extranodal non-Hodgkin lymphomas (NHLs) (1,2) and 1% of all NHLs (3)(4)(5). Diffuse large B-cell lymphoma (DLBCL) is the most common histological type of PBL, and the majority of patients have limited-stage disease (stages IE-IIE) at presentation (4,(6)(7)(8)(9).…”

Primary bone lymphoma involving bilateral tibia

“…It represents 3% of all primary bone malignancies, <2% of all adult lymphomas, and 5% of extranodal lymphomas [2][3][4][5]. Diffuse large B-cell lymphoma accounts for approximately 80% of cases [3,4].…”