Beal K et al. (2006) Primary bone lymphoma: treatment results and prognostic factors with long-term follow-up of 82 patients. Cancer 106: 2652–2656

Data on the optimum management and long-term prognosis of primary bone lymphoma are limited, especially with regard to more-modern treatment modalities using combined chemotherapy and radiotherapy. To address this issue, Beal and colleagues investigated all cases of this relatively rare condition treated at their center (the Memorial Sloan–Kettering Cancer Center) over a 40-year period.

The study analyzed treatment regimen, survival, and prognostic factors for a total of 82 patients (median age 48 years, range 11–83 years) with primary bone lymphoma. The majority (80%) presented with diffuse large-cell lymphoma, and of these 81% had Ann Arbor stage I or II disease. Treatment regimens used were combined-modality therapy (57% of patients), radiation therapy alone (14% of patients), and chemotherapy alone (30% of patients). After a median follow-up of 67 months (range 2–280 months), 5-year overall survival (OS), cause-specific survival (CSS), and freedom from treatment failure (FFTF) were 88%, 96%, and 81%, respectively. Five-year OS and FFTF were significantly higher for patients treated with combined-modality versus single-modality therapy (95% vs 78%, P = 0.013, and 90% vs 67%, P = 0.025, respectively). Favorable prognostic factors for OS, CSS and FFTF were age below 40 years and use of combined-modality therapy.

The data from this cohort of patients support the use of combined radiotherapy and chemotherapy in patients with primary lymphoma involving the bone. Using this modality prognosis is extremely good, with CSS rates of 96%.