Prognostic significance of soft tissue extension, International Prognostic Index, and multifocality in primary bone lymphoma: a single institutional experience

2014 ◽  
Vol 166 (1) ◽  
pp. 60-68 ◽  
Author(s):  
Huanwen Wu ◽  
Ling Zhang ◽  
Haipeng Shao ◽  
Lubomir Sokol ◽  
Eduardo Sotomayor ◽  
...  
Keyword(s):  
Soft Tissue ◽  
International Prognostic Index ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Primary Bone Lymphoma ◽  
Soft Tissue Extension ◽  
Institutional Experience ◽  
Primary Bone ◽  
Bone Lymphoma

Prognostic Significance Of Soft Tissue Involvement and International Prognostic Index In Primary Bone Lymphoma– A Single Institutional Experience

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1781-1781
Author(s):  
Huanwen Wu ◽  
Marilyn Bui ◽  
Haipeng Shao ◽  
Lubomir Sokol ◽  
Eduardo M. Sotomayor ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Soft Tissue ◽  
International Prognostic Index ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Stage Iv ◽  
Soft Tissue Extension ◽  
Institutional Experience ◽  
Primary Bone ◽  
Single Modality

Abstract Introduction Primary bone lymphoma (PBL) is a rare disease, representing approximately 7% of malignant bone tumors and 5% of extranodal lymphomas. There is inconsistent data in the literature regarding to definition, stage and prognostic factors. This study aims to describe our institutional experience in comparison with literature to identify any additional potential prognostic indicators. Materials and methods Following the guidelines of Institutional Review Board, we retrospectively reviewed PBLs at Moffitt Cancer Center from 1998 to 2013 using data from medical record, Cancer Registry, and the Social Security Death Index. The pathological diagnosis was confirmed by experienced study pathologists using WHO classification. Clinical and radiological information was confirmed by study oncologists. Results 70 PBLs were included into our study, and most (n=53, 75.7%) were histologically classified as primary bone diffuse large-cell lymphoma (PB-DLBCL) (Table 1. There was a slight male predominance (1.3:1) with a median age of 56.5 years (15-89). Femur, spine and pelvis were most commonly involved. Most patients present with local bone pain (88.5%). Soft tissue extension is common (55.8%). Multifocal bone lesions and Ann Arbor Stage IV disease were observed in 27 patients (38.6%) and 41 patients (44.3%), respectively. Of 70 PBLs, 38.6% were treated with combined modality therapy, 8.6% were treated with radiation therapy alone, and 48.6% were treated with chemotherapy alone. The data of PB-DLBCL subgroup were further analyzed for survival. The patients with PB-DLBCL had 3- and 5-year progression free survival (PFS) of 61.2% and 46.9% respectively, while 5- and 10-year overall survival (OS) were 81.1% and 74.7% (Figure 1). In univariate analysis, soft tissue extension (p=0.009), multifocal lesions (p=0.002), stage IV (p=0.001), elevated LDH (p=0.027), high International Prognostic Index (IPI) score (p<0.001), and single-modality therapy (p=0.004) were significant poor prognostic factors for PFS. Age ≥60 years (p= 0.012), soft tissue extension (p=0.015), multifocal lesions (p<0.001), stage IV (p=0.001), elevated LDH (p= 0.034), high Performance Score (p=0.036), high IPI score (p<0.001), and single-modality therapy (p=0.021) were significant poor prognostic factors for OS. Multivariate analysis revealed that soft tissue extension and IPI score were two independent prognostic factors for both PFS and OS in patients with PB-DLBCL (Table 2). Conclusion Our institutional experience confirms, although PB-DLBCL comprises the majority of PBL, the overall prognosis of PBL is good. In PB-DLBCL, soft tissue extension and higher IPI score are associated with an inferior OS and PFS. The authors emphasized that prognostic significance of soft tissue extension and IPI in PBL are not well discussed in the literature, which warrants further investigation in larger well-characterized clinical cohorts. Disclosures: No relevant conflicts of interest to declare.

Primäres Knochenlymphom: Klinische Analyse von 17 Patienten in derselben Institution

2015 ◽  
Vol 2 (2) ◽  
pp. 90-91
Keyword(s):  
International Prognostic Index ◽  
Prognostic Index ◽  
Complete Response ◽  
Clinical Analysis ◽  
Single Institution ◽  
Primary Bone Lymphoma ◽  
Stadium Iv ◽  
Primary Bone ◽  
Bone Lymphoma

Primäre Knochenlymphome (primary bone lymphomas; PBL) machen weniger als 1% aller malignen Lymphome aus. Da in Japan erst wenige Studien zu PBL durchgeführt wurden, sind die Merkmale der PBL bei japanischen Patienten nicht vollständig geklärt. Wir analysierten retrospektiv 17 Patienten, bei denen zwischen 2001 und 2011 in unserer Einrichtung ein PBL diagnostiziert worden war. Der Altersmedian der Patienten betrug 60 Jahre. Elf Patienten hatten ein diffuses großzelliges B-Zell-Lymphom und 2 eine T-Zell-Lymphom-Histologie. Die Wirbelsäule war zum Zeitpunkt der Erstvorstellung am häufigsten betroffen. Bei 11 Patienten war die Krankheit im Stadium IV, und 11 Patienten wiesen laut dem International Prognostic Index (IPI) ein hohes oder mittleres bis hohes Risiko auf. 13 Patienten erreichten nach der initialen Therapie eine Vollremission (complete response; CR). Nach einer medianen Nachbeobachtungszeit von 31 Monaten betrug die 3-Jahres-Rate des Gesamtüberlebens (OS) und des progressionsfreien Überlebens 63,5 bzw. 49,9%. Eine lokal begrenzte Erkrankung, ein niedriges oder niedriges bis mittleres IPI-Risiko und eine CR nach initialer Therapie waren bei den PBL-Patienten mit einem guten Verlauf und signifikant mit einem besseren OS assoziiert. Eine Beteiligung der Wirbelsäule und der T-/NK-Zell-Phänotyp kommen bei japanischen PBL-Patienten häufiger vor als bei solchen kaukasischen Ursprungs. Übersetzung aus Hayase E, et al: Primary Bone Lymphoma: A Clinical Analysis of 17 Patients in a Single Institution. Acta Haematol 2015;134:80-85 (DOI: 10.1159/000375437)

scholarly journals Primary Bone Lymphoma: An Experience of a Regional Cancer Center from India

2020 ◽  
Vol 09 (04) ◽  
pp. 227-229
Author(s):  
Rohit Mahajan ◽  
Budhi Singh Yadav ◽  
Suresh Chander Sharma ◽  
Ankita Gupta ◽  
Shikhar Kumar
Keyword(s):  
International Prognostic Index ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Clinical Staging ◽  
Histologic Subtype ◽  
Primary Bone Lymphoma ◽  
Number Of Patients ◽  
Primary Bone ◽  
Hodgkin's Lymphomas ◽  
Bone Lymphoma

Abstract Background Primary bone lymphoma (PBL) is a rare disease, representing <5% of all extranodal non-Hodgkin’s lymphomas (NHLs). The optimal treatment strategy is still unclear. Here, we report our institutional outcome analysis of patients diagnosed with PBL. Materials and Methods From 2007 to 2014, the medical records of 22 patients with PBL were reviewed. Analysis was done for symptom-, patient-, disease-, and treatment-related characteristics. All patients were treated with chemotherapy with or without radiotherapy. Treatment response and impact of different prognostic factors on clinical outcome were analyzed. Results The median age of presentation was 44 years (range: 18–70 years). A total of 19 (86.4%) patients were ≤60 years of age and 3 (13.6%) patients were >60 years. Out of all, 18 were males and 4 were females. Ann Arbor clinical staging at diagnosis was Stage I in 13 (59.1%), Stage II in 3 (13.6%), Stage III in 2 (9.1%), and Stage IV in 4 (18.2%) patients. Spine was the most common site of involvement seen in 12 (54.5%) patients. Diffuse large B cell lymphoma histology was seen in 8 (36.4%) patients and 8 (36.4%) had high-grade NHL. Chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone was given to 20 (90.9%) patients, whereas 2 (9.1%) patients received cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab. Radiotherapy (30-40 Gy) was delivered to 19 (86.4%) patients. The median follow-up period was 40 months (range: 8–105 months). The overall response rate was 86.3% with complete response (CR) in 15 (68.1%) and partial response in 4 (18.2%) patients. Relapses were seen in three (13.5%) patients: two nodal, and one in the bone. Disease-free survival (DFS) and overall survival (OS) at 5 years were 56.6 and 72.7%, respectively. CR after initial treatment was associated with a significant better OS, 80 and 25%, respectively (p < 0.0001). Age, sex, stage, International Prognostic Index, histologic subtype, and number of sites had no significant influence on OS. Combining radiation therapy with chemotherapy (with or without rituximab) also did not improve the OS or DFS of patients. Conclusion In spite of small number of patients reported in this study, conventional chemotherapy remains an effective treatment option for patients with PBL. OS was found to be affected by the initial response to treatment.

Primary Bone Lymphoma: A Clinical Analysis of 17 Patients in a Single Institution

2015 ◽  
Vol 134 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Eiko Hayase ◽  
Mitsutoshi Kurosawa ◽  
Hiroaki Suzuki ◽  
Kohei Kasahara ◽  
Tomohiro Yamakawa ◽  
...  
Keyword(s):  
Initial Treatment ◽  
Nk Cell ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Cell Phenotype ◽  
Primary Bone Lymphoma ◽  
Primary Bone ◽  
Bone Lymphoma

Primary bone lymphoma (PBL) comprises less than 1% of all malignant lymphomas. Because few studies of PBL have been conducted in Japan, the characteristics of Japanese patients with PBL have not been fully elucidated. We retrospectively analyzed 17 patients diagnosed with PBL at our institution between 2001 and 2011. Median patient age was 60 years. Eleven patients had diffuse large B-cell lymphoma and 2 patients had T-cell lymphoma histology. The spine was the most frequently involved site at the time of presentation. There were 11 patients with stage IV disease and 11 patients with high or high-intermediate risk according to the International Prognostic Index (IPI). Thirteen patients achieved complete response (CR) after initial treatment. At a median follow-up of 31 months, the 3-year overall survival (OS) and progression free survival were 63.5 and 49.9%, respectively. Localized disease, low or low-intermediate IPI, and CR after initial treatment were associated with a good outcome in patients with PBL and significantly associated with a better OS. Spine involvement and T/NK-cell phenotype are more frequent in Japanese than in Caucasian patients with PBL.

scholarly journals Imaging Features and Floating-Ice Sign of Primary Lymphoma of the Bone

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Bao-Hai Yu ◽  
Tao Sun ◽  
Lei Cao ◽  
Shu-Man Han ◽  
Wen-Juan Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Long Bone ◽  
Bone Lesions ◽  
Imaging Features ◽  
Primary Bone Lymphoma ◽  
Hyperintense Signal ◽  
Soft Tissue Masses ◽  
Primary Bone ◽  
Hypointense Signal ◽  
Bone Lymphoma

Background: The imaging presentation of primary bone lymphoma is unclear. Objectives: The present study aimed to investigate the imaging presentations of primary bone lymphoma especially a specific “floating-ice” sign. Patients and Methods: Forty one patients with primary bone lymphoma confirmed by pathology with 27 males and 14 females and an age range of 2 - 76 (mean = 40) years were enrolled. The clinical and imaging data were analyzed. Results: The tumor involved long bones in 17 cases, flat bones in 12, spine in eight and irregular bones in four cases. The imaging presentations were divided into five types: infiltrative type in nine cases (22%), osteolytic in 14 cases (34.1%), osteosclerotic in four cases (9.8%), mixed in 11 cases (26.8%) including four cases with a “floating-ice” sign and cystic in three cases (7.3%). In plain radiography, only three of four long bone lesions in children had a varying degree of periosteal reaction. Among 20 cases with CT scanning, sixteen had soft tissue masses, seventeen had ill-defined margins, and three had well-defined margins with sclerotic rims. Among twelve patients with MRI, ten had soft tissue masses with well-defined margins. MRI demonstrated a greater extent of lesion than CT. In MRI T1 weighted image (T1 WI), isointense signal was seen in three cases, hypointense signal in five and mixed signal in four. In T2 WI, isointense and hypointense signal was detected in five cases, hyperintense signal in three and mixed hyperintense signal in four. Conclusion: Primary bone lymphoma occurs most frequently in long and flat bones as infiltrative osteolytic destruction, and combined plain radiographs, CT and MRI help obtain a correct diagnosis.

scholarly journals Belated Diagnosis of a Primary Bone Lymphoma of the Elbow: A Rare Case and Review of the Literature

2020 ◽  
pp. 100-107
Author(s):  
Michele Boffano ◽  
Nicola Ratto ◽  
Martina Rezzoagli ◽  
Andrea Conti ◽  
Pietro Pellegrino ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Rare Disease ◽  
Rare Case ◽  
Early Stage ◽  
Bone Lesions ◽  
Review Of The Literature ◽  
Primary Bone Lymphoma ◽  
Lytic Bone Lesions ◽  
Primary Bone ◽  
Bone Lymphoma

Primary non-Hodgkin bone lymphoma (PBL) is a rare disease that accounts for <2% of all lymphomas in adults. PBL can be monostotic or polyostotic, mainly causing destructive and lytic bone lesions frequently located in the femur, humerus, and pelvis. PBL is rarely considered a differential diagnosis of the osteolytic tumor. In addition, PBL is not uncommonly diagnosed with delay because patients do not experience symptoms nor show objective abnormalities in the early stage of disease. Here, we reported a 60-year-old woman with a PBL of the elbow.

Prognostic significance of bcl-xL gene expression and apoptotic cell counts in follicular lymphoma

Blood ◽  
2004 ◽  
Vol 103 (2) ◽  
pp. 695-697 ◽  
Author(s):  
Wei-Li Zhao ◽  
Marjan Ertault Daneshpouy ◽  
Nicolas Mounier ◽  
Josette Brière ◽  
Christophe Leboeuf ◽  
...  
Keyword(s):  
Gene Expression ◽  
Follicular Lymphoma ◽  
Apoptotic Cell ◽  
International Prognostic Index ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Pcr Analysis ◽  
Survival Times ◽  
Lymphoma Cells ◽  
Cell Counts

Abstract bcl-xL, a member of the Bcl-2 family, exerts an antiapoptotic effect on lymphocytes. To assess its clinical significance in patients with follicular lymphoma, realtime quantitative reverse transcription–polymerase chain reaction (RT-PCR) analysis of bcl-xL gene expression was investigated in whole lymph node sections and laser-microdissected lymphoma cells of 27 patients. Compared with 10 patients with reactive follicular hyperplasia, the bcl-xL gene was overexpressed in patients with follicular lymphoma at a higher level in microdissected lymphoma cells. The bcl-xL gene level correlated with the number of apoptotic lymphoma cells labeled by terminal deoxytransferase-catalyzed DNA nick-end labeling (TUNEL) assays (r = -0.7736). Clinically, a high bcl-xL level was significantly associated with multiple sites of extranodal involvement (P = .0020), elevated lactate dehydrogenase level (P = .0478), and an International Prognostic Index indicating high risk (P = .0235). Moreover, bcl-xL gene overexpression was linked to short overall survival times (P = .0129). The value of bcl-xL gene expression as a prognostic marker in follicular lymphoma should thus be considered.

scholarly journals Clinical characteristics and outcomes of primary bone lymphoma in Korea

2012 ◽  
Vol 47 (3) ◽  
pp. 213 ◽  
Author(s):  
So Yeon Kim ◽  
Dong-Yeop Shin ◽  
Seung-Sook Lee ◽  
Cheolwon Suh ◽  
Jae-Yong Kwak ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Primary Bone Lymphoma ◽  
Primary Bone ◽  
Bone Lymphoma

High numbers of tumor-infiltrating FOXP3-positive regulatory T cells are associated with improved overall survival in follicular lymphoma

Blood ◽  
2006 ◽  
Vol 108 (9) ◽  
pp. 2957-2964 ◽  
Author(s):  
Joaquim Carreras ◽  
Armando Lopez-Guillermo ◽  
Bridget C. Fox ◽  
Lluis Colomo ◽  
Antonio Martinez ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cells ◽  
Regulatory T Cells ◽  
Follicular Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Specific Cell ◽  
First Relapse ◽  
The Impact

Abstract The tumor microenvironment plays an important role in the biologic behavior of follicular lymphoma (FL), but the specific cell subsets involved in this regulation are unknown. To determine the impact of FOXP3-positive regulatory T cells (Tregs) in the progression and outcome of FL patients, we examined samples from 97 patients at diagnosis and 37 at first relapse with an anti-FOXP3 monoclonal antibody. Tregs were quantified using computerized image analysis. The median overall survival (OS) of the series was 9.9 years, and the FL International Prognostic Index (FLIPI) was prognostically significant. The median Treg percentage at diagnosis was 10.5%. Overall, 49 patients had more than 10% Tregs, 30 between 5% to 10%, and 19 less than 5%, with a 5-year OS of 80%, 74%, and 50%, respectively (P = .001). Patients with very low numbers of Tregs (< 5%) presented more frequently with refractory disease (P = .007). The prognostic significance of Treg numbers was independent of the FLIPI. Seven transformed diffuse large B-cell lymphomas (DLBCLs) had lower Treg percentages (mean: 3.3%) than FL grades 1,2 (mean: 12.1%) or 3 (mean: 9%) (P < .02). In conclusion, high Treg numbers predict improved survival of FL patients, while a marked reduction in Tregs is observed on transformation to DLBCL.

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