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Primary bone marrow diffuse large B cell lymphoma: a case series and review
Hung Chang1, Yu-Shin Hung, Tung-Liang Lin
1Division of Hematology-Oncology, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, Taiwan, Republic of China.
Annals of Hematology
|December 25, 2010
Summary
Primary bone marrow diffuse large B cell lymphoma (DLBCL) is a rare condition. Rituximab-based chemotherapy shows promise for improving outcomes in patients with this aggressive lymphoma subtype.
Area of Science:
- Hematology
- Oncology
- Clinical Research
Background:
- Diffuse large B cell lymphoma (DLBCL) commonly involves the bone marrow secondarily.
- Primary, de novo DLBCL originating in the bone marrow is an exceptionally rare clinical entity.
Observation:
- A single-center study identified 12 cases of primary bone marrow DLBCL over 5 years.
- These cases represented 1.16% of all lymphomas and 2.65% of DLBCL cases.
- Common presentations included fever of unknown origin and elevated lactate dehydrogenase levels, with most patients classified as high-risk.
Findings:
- Patients receiving no chemotherapy had a median survival of less than 1 month.
- Standard cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP)-like chemotherapy resulted in a median survival of 13 months.
- Adding rituximab to CHOP-like chemotherapy achieved complete remission in all patients, with three remaining relapse-free.
Implications:
- Primary bone marrow DLBCL is a distinct subtype with a generally poor prognosis.
- Rituximab-containing regimens offer a promising therapeutic strategy for improving survival in this rare lymphoma.
- Further research into optimal treatment protocols for primary bone marrow DLBCL is warranted.
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