[Skeletal involvement in Hodgkin's lymphoma--personal experience]

To assess the incidence and prognostic significance of osseous Hodgkin's lymphoma.

The authors retrospectively analyzed 85 patients treated at their institutions between 1995-2001. They assessed the incidence of bone involvement, involved localities and basic characteristics of the subgroup (age, gender, stage, histology). All patients were treated according to the protocols of the German Hodgkin Study Group (GHSG). Treatment response, disease free- and overall survival were evaluated with special attention to predictive and prognostic significance of bone involvement.

From the total of 85 eligible patients 10 cases of bone involvement were recorded of who seven were diagnosed primarily and three at relapse. Most frequently involved were lumbar vertebrae. Diagnosis was based on CT and bone scan, biopsy was performed only in one case. In the evaluated subgroup, there was apparently higher incidence of advanced stage disease, other parameters did not differ from the control group. Of the 10 patients, six achieved complete remission, two uncertain complete remission and two progressed primarily. At present, eight patients are alive in complete remission, one is being treated with salvage chemotherapy and high dose therapy with autologous stem cell transplantation. One patient expired due to progressive disease. Median overall survival is 12 months.

Bone involvement is not an adverse predictive factor for treatment response in Hodgkin's lymphoma. Because of short follow-up period seems preliminary to evaluate its prognostic power for disease free- and overall survival.