Clinical characteristics and prognostic analysis of primary malignant bone lymphoma

Objective: To investigate the clinical features and prognostic factors of primary bone lymphoma (PBL). Methods: A retrospective analysis was performed based on the clinical records of 37 PBL cases treated at the Tianjin Medical University Cancer Hospital between June 1995 and May 2009. Survival curves were plotted using the Kaplan-Meier method, with the Log-rank COX regression model to evaluate the independent prognostic factors. Results: The median age of patients was 61 years (range 18-85 years). Ostealgia was the initial symptom. The majority of cases presented with diffuse large B-cell non-Hodgkin's lymphoma. Through chemotherapy and/or radiotherapy, 18 patients achieved complete remission (CR) and 13 achieved partial remission (PR), with a median follow-up of 32 months (7-171 months). The 5- and 10-year overall survival rates were 59.5% and 43.2%, respectively. The patients treated with chemotherapy ≥4 cycles combined with rituximab for B cell lymphoma achieved better outcomes. In the multivariate analysis, the Ann Arbor stage, B symptoms, ages, and the number of extranodal involvement sites were independent prognostic factors. Conclusion: Primary bone non-Hodgkin's lymphoma should be treated with a multi-modality strategy. Treatment with more than 4 cycles of doxorubicin-based chemotherapy after orchiectomy is recommended. For B cell lymphoma, rituximab plus chemotherapy is preferred. Pamidronate disodium is necessary. The Ann Arbor stage, B symptom, age, and number of extranodal sites are independent prognostic factors of PBL.