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Primary non‐Hodgkin's lymphoma of bone. A clinicopathologic study
Author(s) -
Baar Joseph,
Burkes Ronald L.,
Bell Robert,
Blackstein Martin E.,
Fernandes Bernard,
Langer Fred
Publication year - 1994
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19940215)73:4<1194::aid-cncr2820730412>3.0.co;2-r
Subject(s) - medicine , lymphoma , stage (stratigraphy) , radiation therapy , chemotherapy , non hodgkin's lymphoma , regimen , radiology , anthracycline , surgery , cancer , paleontology , biology , breast cancer
Background . This study relates our experience in the diagnosis and treatment of a rare clinical entity, non‐Hodgkin's primary lymphoma of bone. Methods . Seventeen cases of patients with primary lymphoma of bone diagnosed and treated at a single institution between 1975 and 1992 are reviewed. Ten patients received combined‐modality therapy, consisting of an anthracycline‐containing combination chemotherapy (CT) regimen, followed by adjuvant radiotherapy (RT) to the primary site of disease. Five patients were treated with CT alone; one patient received RT alone; and one patient was treated with CT after emergency RT for spinal cord compression. Results . Thirteen patients presented with Stage I disease, two with Stage II; and two with Stage IV disease (multiple bony sites only). Thirteen patients had an intermediate‐grade diffuse large cell lymphoma; two had an intermediate‐grade mixed small and large cell lymphoma; and two had a high‐grade lymphoma (one immunoblastic and one small non‐cleaved cell lymphoma). The overall response rate was 94% (18% complete response, 58% partial response 1, and 18% partial response 2). Thirteen patients are alive and disease‐free at a median of 29 months; 10 of these received CT + RT, and 3 received CT alone. Three patients have died; one of these received CT + RT and one CT alone, and one relapsed immediately after CT. One patient, who was initially treated with RT and then with CT + RT after relapse, was lost to follow‐up 40 months from the start of treatment. Conclusions . Because experience in the literature suggests a 50% distant relapse rate in primary lymphoma of bone treated with RT alone, our policy is to treat all patients with combined‐modality therapy (CT + RT). However, only a Phase III randomized, controlled clinical trial will determine whether CT + RT is superior to either modality alone.