Korean J Hematol.  2012 Sep;47(3):213-218. 10.5045/kjh.2012.47.3.213.

Clinical characteristics and outcomes of primary bone lymphoma in Korea

• Kim SY
• Shin DY
• Lee SS
• Suh C
• Kwak JY
• Kim HG
• Lee JH
• Lee SI
• Lee YR
• Kang SH
• Mun SK
• Lee MJ
• Lee HR
• Yang SH
• Kang HJ

• KMID: 2251956
• DOI: http://doi.org/10.5045/kjh.2012.47.3.213

Abstract

BACKGROUND
This study evaluates the effectiveness of immunochemotherapy and radiation therapy in the treatment of patients with primary bone lymphoma (PBL).
METHODS
We retrospectively reviewed the medical records of 33 patients with PBL who were treated at 6 medical centers in Korea from 1992 to 2010. Clinicopathological features and treatment outcomes were analyzed.
RESULTS
The median age of the patients participating in our study was 40 years. The most common sites of involvement were the pelvis (12.36%) and femur (11.33%). CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) or CHOP-like regimens were administered to 20 patients (61%), and R-CHOP (rituximab plus CHOP) was administered to the remaining 13 patients (39%). The overall response rate was 89% (complete response, 76%; partial response, 12%). The overall survival (OS) of patients with solitary bone lesions was longer than that of patients with multiple bone lesions (median OS: not reached vs. 166 months, respectively; P=0.089). Addition of rituximab to CHOP did not significantly affect either OS or progression-free survival (P=0.53 and P=0.23, respectively). Combining radiation therapy with chemotherapy also did not improve the OS or progression-free survival of patients with solitary bone lesions.
CONCLUSION
Conventional cytotoxic chemotherapy remains an effective treatment option for patients with PBL. Additional benefits of supplementing chemotherapy with either rituximab or radiation therapy were not observed in this study. Further investigation is needed to characterize the role of immunochemotherapy in treating patients with PBL.

Keyword

Bone lymphoma; Radiotherapy; Rituximab

MeSH Terms

Antibodies, Monoclonal, Murine-Derived
Disease-Free Survival
Doxorubicin
Femur
Humans
Korea
Lymphoma
Medical Records
Pelvis
Retrospective Studies
Vincristine
Rituximab
Antibodies, Monoclonal, Murine-Derived
Doxorubicin
Vincristine

Figure

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  Fig. 1 Overall survival of all participating patients with primary bone lymphoma (median overall survival: 166 months, 95% CI: 0-339).

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  Fig. 2 Survival by number of bones involved. (A) Overall survival (OS) of patients with solitary bone lesions compared to that of patients with multiple bone lesions (median OS: not reached vs. 166 months, P=0.089) and (B) Progression-free survival (PFS) of patients with solitary bone lesions compared to that of patients with multiple bone lesions (median PFS: 74 months vs. 74 months, P=0.99).

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  Fig. 3 Progression-free survival of patients with solitary bone lesions treated with radiation therapy (Median progression-free survival: 74 months vs. 87 months, P=0.78). Abbreviation: RT, radiation therapy.

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  Fig. 4 Overall survival of patients at stage IV of the disease, treated with rituximab (Median overall survival: not reached, P=0.53).

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