Primary bone lymphoma: Clinical presentation and therapeutic considerations

Area of Science:

• Oncology
• Hematology
• Radiology

Background:

• Primary lymphoma of bone (PBL) is a rare malignancy.
• Diagnosis can be delayed due to non-specific symptoms and ambiguous radiographic findings.

Purpose of the Study:

• To evaluate treatment strategies and prognostic factors in 109 primary bone lymphoma cases.
• To analyze factors influencing overall survival (OS) in PBL patients.

Main Methods:

• Retrospective review of 109 patient records.
• Follow-up for local or distant recurrence.
• Overall survival (OS) as the primary clinical outcome measure.

Main Results:

• Median patient age was 62.8 years; common symptoms included pain, swelling, and fractures.
• Aggressive non-Hodgkin lymphoma (NHL) subtypes were prevalent (72%).
• Chemotherapy (CHOP/RCHOP) and radiotherapy were common treatments; 5-year OS was 66%. Age and elevated lactate dehydrogenase (LDH) were significant prognostic factors in multivariate analysis.

Conclusions:

• Chemotherapy demonstrates superior outcomes compared to radiotherapy alone for primary bone lymphoma.
• Favorable long-term survival is associated with early disease stage, younger age (<60 years), solitary bone lesions, low LDH levels, and good ECOG performance and IPI scores.