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Outcome of primary bone lymphoma: Single center experience

Date

08 Oct 2016

Session

Poster Display

Presenters

M Rauf

Citation

Annals of Oncology (2016) 27 (6): 313-327. 10.1093/annonc/mdw375

Authors

M.S. Rauf, S. Akhtar, A. Badran, M.A. Ilyas, Q. Shaikh, M.N. Zahir, Y. Khafaga, I. Maghfoor

Author affiliations

  • Medical Oncology, King Faisal Specialist Hospital and Research Center, 11211 - Riyadh/SA
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Resources

Background

Primary bone lymphoma (PBL) represents less than 1% of all malignant lymphomas. In this retrospective study, we assessed the disease profile, outcome, and prognostic factors in PBL patients.

Methods

All patients treated at our center between 1987 and 2013 were reviewed, 113 cases were identified

Results

Male: female 1:1.5, median age 35 years (14-77 yrs), diffuse large B cell lymphoma 86%. Stage I-II in 51/108 and stage III-IV in 57/108 patients. Bulky disease in 56%, B symptoms present in 40% patients. Median follow up (survivors) is 60 months (39,75 interquartile range). 108 patients received curative intent treatment, chemotherapy (CT) alone in 26%, radiation and CT (CTXRT) in 74%. Median radiation dose was 38 Gy (range 30-60 Gy), 96/108 received 6-8 cycles of chemotherapy. At the end of planned treatment, 82.5% were in complete remission (CR), 13.8% showed partial response and only 4 patients had primary progressive disease. Systemic relapse or progression was observed in 22%, with no local recurrence. 5-year overall survival (OS), and progression free survival (PFS) were 82.5% and 76.2% respectively. Disease status at last follow-up was 77 % patients were alive and in CR, 2% alive with disease, 16% died of disease and 5% died of another cause or lost to follow-up. 28 patients progressed or relapsed, 6 received high dose CT and autologous bone marrow transplant (all are alive and in CR) and 19 died of disease. In univariate analyses (log rank test), favorable prognostic factors for PFS were low or low intermediate International Prognostic Index (IPI) score (P = 0.06), CTXRT (P = 0.033), and no B symptoms (P = 0.001). For OS, low or low intermediate IPI score (P = 0.007), stage I-II disease (P = 0.05), CTXRT (P = 0.005), and no B symptoms (P = 0.01) were favorable. Multivariate analysis showed low or low intermediate IPI score, CTXRT and no B symptoms independently influencing PFS. Absence of B symptoms was the only predicting factor for OS.

Conclusions

This is largest data from the Middle East. PBL has good prognosis. Local control is excellent, and systemic failure occurs infrequently. Good IPI score (

Clinical trial identification

Legal entity responsible for the study

Institutional review board of King Faisal Hospital and Research Center

Funding

Institutional review board of King Faisal Hospital and Research Center

Disclosure

All authors have declared no conflicts of interest.

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