• Media type: E-Article
  • Title: Clinical features, management and prognosis of multifocal primary bone lymphoma: a retrospective study of the international extranodal lymphoma study group (the IELSG 14 study)
  • Contributor: Messina, Carlo; Ferreri, Andrés J. M.; Govi, Silvia; Bruno‐Ventre, Marta; Gracia Medina, Elías A.; Porter, David; Radford, John; Heo, Dae S.; Park, Hee Y.; Pro, Barbara; Jayamohan, Jayasingham; Visco, Carlo; Scarfò, Lydia; Zucca, Emanuele; Gospodarowicz, Mary; Christie, David
  • Published: Wiley, 2014
  • Published in: British Journal of Haematology
  • Extent: 834-840
  • Language: English
  • DOI: 10.1111/bjh.12714
  • ISSN: 0007-1048; 1365-2141
  • Keywords: Hematology
  • Abstract: <jats:title>Summary</jats:title><jats:p>‘Multifocal bone lymphoma’ or ‘polyostotic lymphoma’ is a neoplasm with exclusive multifocal involvement of the skeleton, without affecting lymph nodes or other soft tissues. Knowledge on this uncommon condition is limited because the related literature is sparse and fragmentary. We reviewed cases of multifocal bone diffuse large B‐cell lymphoma (<jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content>) registered in a clinico‐pathological database of the International Extranodal Lymphoma Study Group that includes 499 cases of bone lymphoma. Clinical features, management and prognosis of 37 <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients and 63 ‘controls’ (stage‐<jats:styled-content style="fixed-case">IV DLBCL</jats:styled-content> and skeletal involvement) were analysed. Presentation and treatment of <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> and controls were identical. At a median follow‐up of 52 months (10–189), <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients exhibited a significantly better response rate (92% vs. 65%; <jats:italic>P</jats:italic> = 0·002), progression‐free survival (5‐year: 56 ± 9% vs. 34 ± 6%; <jats:italic>P</jats:italic> = 0·003) and overall survival (5‐year: 74 ± 8% vs. 36 ± 7%; <jats:italic>P</jats:italic> = 0·002). Among <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients, the use of post‐chemo radiotherapy was associated with better overall survival (5‐year: 83 ± 12% vs. 55 ± 16%; <jats:italic>P</jats:italic> = 0·003). Two <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients (5·4%) with spine and skull involvement experienced central nervous system (<jats:styled-content style="fixed-case">CNS</jats:styled-content>) relapse. Thus, <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients exhibit a significantly better prognosis compared to patients with advanced‐stage <jats:styled-content style="fixed-case">DLBCL</jats:styled-content>, and should be treated with conventional anthracycline‐based chemotherapy, keeping intensified treatment for relapsing cases, considering involved‐field radiotherapy, and <jats:styled-content style="fixed-case">CNS</jats:styled-content> prophylaxis in high‐risk patients.</jats:p>
  • Description: <jats:title>Summary</jats:title><jats:p>‘Multifocal bone lymphoma’ or ‘polyostotic lymphoma’ is a neoplasm with exclusive multifocal involvement of the skeleton, without affecting lymph nodes or other soft tissues. Knowledge on this uncommon condition is limited because the related literature is sparse and fragmentary. We reviewed cases of multifocal bone diffuse large B‐cell lymphoma (<jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content>) registered in a clinico‐pathological database of the International Extranodal Lymphoma Study Group that includes 499 cases of bone lymphoma. Clinical features, management and prognosis of 37 <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients and 63 ‘controls’ (stage‐<jats:styled-content style="fixed-case">IV DLBCL</jats:styled-content> and skeletal involvement) were analysed. Presentation and treatment of <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> and controls were identical. At a median follow‐up of 52 months (10–189), <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients exhibited a significantly better response rate (92% vs. 65%; <jats:italic>P</jats:italic> = 0·002), progression‐free survival (5‐year: 56 ± 9% vs. 34 ± 6%; <jats:italic>P</jats:italic> = 0·003) and overall survival (5‐year: 74 ± 8% vs. 36 ± 7%; <jats:italic>P</jats:italic> = 0·002). Among <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients, the use of post‐chemo radiotherapy was associated with better overall survival (5‐year: 83 ± 12% vs. 55 ± 16%; <jats:italic>P</jats:italic> = 0·003). Two <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients (5·4%) with spine and skull involvement experienced central nervous system (<jats:styled-content style="fixed-case">CNS</jats:styled-content>) relapse. Thus, <jats:styled-content style="fixed-case">MB</jats:styled-content>‐<jats:styled-content style="fixed-case">DLBCL</jats:styled-content> patients exhibit a significantly better prognosis compared to patients with advanced‐stage <jats:styled-content style="fixed-case">DLBCL</jats:styled-content>, and should be treated with conventional anthracycline‐based chemotherapy, keeping intensified treatment for relapsing cases, considering involved‐field radiotherapy, and <jats:styled-content style="fixed-case">CNS</jats:styled-content> prophylaxis in high‐risk patients.</jats:p>
  • Footnote: