Primary Bone Diffuse Large B-cell Lymphoma

Bhagavathi, Sharathkumar; Micale, Mark A.; Les, Kimberly; Wilson, Jon D.; Wiggins, Michele L.; Fu, Kai

doi:10.1097/pas.0b013e3181b314ce

Cited by 40 publications

(13 citation statements)

References 11 publications

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“…A previous study aimed at nodal DLBCL, suggested that the prognosis of the GCB subtype is better than that of the non-GCB subtype in using standard chemotherapy 37 . In our study, 23 cases of 34 PB-DLBCL patients could be further divided into GCB type (11 cases) and non-GCB type (12 cases), but the 5-year OS and PFS between the 2 groups did not reach statistical significance, which is in accordance with reports from Bhagavathi et al 38 and Heyning et al 31 , but the sample sizes were small and the influence of molecular subtypes on prognosis remains to be elucidated.…”

Section: Discussionsupporting

confidence: 90%

Clinical characterization and outcome of primary bone lymphoma: a retrospective study of 61 Chinese patients

Zhang

Zhu

Song

et al. 2016

Sci Rep

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Primary bone lymphoma(PBL) is a rare disease. To assess the clinical characteristics, outcome, and prognostic factors of this entity in Chinese population, we retrospectively analyzed 61 PBL patients initially treated in our institution between 1997 and 2014. The median age was 45 years. The most common histological subtype was diffuse large B-cell lymphoma (DLBCL) (55.7%), followed by T-cell lymphoma (18.0%). All patients underwent systemic chemotherapy as initial treatment while 24 patients (39.3%) were additionally treated with radiotherapy. The 5-year overall survival (OS) and the 5-year progression-free survival (PFS) rates of 57 cases with completed follow-up were 52.3% and 40.1%, respectively. In further analysis of the primary bone DLBCL (PB-DLBCL) subgroup, the 5-year OS and PFS rates were 53.0% and 47.0%, and a multivariable analysis revealed that baseline Eastern Cooperative Oncology Group (ECOG) score and response to initial treatment (complete remission versus no complete remission) were independent prognostic factors for both OS and PFS. The proportion of T-cell lymphoma is higher in China than in western populations. High baseline ECOG scores (≥2) and unachieved CR in initial therapy were factors for poor PB-DLBCL prognosis. The role of radiotherapy and rituximab in PLB therapy remains to be confirmed in further investigation.

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Section: Discussionsupporting

confidence: 90%

Clinical characterization and outcome of primary bone lymphoma: a retrospective study of 61 Chinese patients

Zhang

Zhu

Song

et al. 2016

Sci Rep

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“…Regarding the subclassification of PBL, several studies with small sample sizes have described the IHC characteristics of PB-DLBCL [ 18 – 21 ]. In these previous reports, approximately half of the PB-DLBCL cases demonstrated a germinal center B-cell (GCB) phenotype by IHC with high Bcl-2 and/or Bcl-6 expression and relatively low MUM-1 expression.…”

Section: Discussionmentioning

confidence: 99%

“…Despite so, 26 of 43 patients were able to be classified with PB-DLBCL in our series according to CD10-positivity, which meant that at least 60.5% of these patients were of GCB phenotype. Prior studies have yielded conflicting results about the predictive value of these IHC markers, particularly of CD10 and GCB stubtype [ 5 , 18 – 21 ]. Although insufficient for subclassification of GCB or non-GCB subtype of PB-DLBCL, our limited data showed no association between various markers (CD10, Bcl-6, Bcl-2, MUM-1) and survival in PB-DLBCL.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognostic factors of bone lymphomas: focus on the clinical significance of multifocal bone involvement by primary bone large B-cell lymphomas

Leston

Shao

et al. 2014

BMC Cancer

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BackgroundMalignant bone lymphoma can be classified as primary (PBL) or secondary (SBL) bone lymphoma. However, the clinico-pathological characteristics and prognostic factors of PBL versus SBL have not yet been well defined. Whether lymphoma with multifocal bone involvement should be considered as stage IV PBL or SBL still remain controversial throughout the literature.MethodsIn this study, we retrospectively reviewed 127 patients with bone lymphoma diagnosed from1998 to 2013 at the Moffitt Cancer Center. Patients were classified as PBL (81 cases) and SBL (46 cases) using the 2013 WHO Classification of Bone/Soft Tissue Tumors and PBL patients were further subdivided into: 1) PBL with unifocal bone disease (uPBL, 46 cases), 2) PBL with multifocal bone involvement (mPBL, 35 cases). Patient characteristics, survival, and prognostic factors were analyzed.ResultsDiffuse large B-cell lymphoma (DLBCL) was the most common histological subtype in all three groups (37/46 of uPBL, 23/35 of mPBL, 23/46 of SBL). B symptoms, lymph node involvement, and bone marrow involvement were found to be more common in mPB-DLBCL and SB-DLBCL groups than in the uPB-DLBCL group. Femur was found to be the most common affected site in uPB-DLBCL patients, while spine was most commonly involved in the other two groups. Survival analysis indicated that uPBL-DLBCL patients had a significantly better progression-free survival (PFS) and overall survival (OS) than those in the other two groups (P < 0.05). We also found by univariate analysis that multifocality, and stage IV were significantly poor prognostic factors for both PFS and OS in PBL patients. Using multivariate analysis, multifocality remained an independent prognostic factor for both PFS and OS (P = 0.0117, RR: 3.789, 95% CI: 1.275-11.256).ConclusionOverall, our results suggest that mPBL is more similar to SBL in characteristics and survival rather than uPBL, and thus should be better classified and treated as SBL.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2407-14-900) contains supplementary material, which is available to authorized users.

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“…The histological and immunohistochemical appearance of PBL has been reported in a number of studies [ 2 , 3 , 4 , 7 , 8 , 9 , 14 , 15 , 16 , 18 , 19 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ,…”

Section: Histological Findingsmentioning

confidence: 99%

Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis

et al. 2023

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Primary bone lymphoma (PBL) is a rare neoplasm of malignant lymphoid cells presenting with one or more bone lesions without nodal or other extranodal involvement. It accounts for approximately 1% of all lymphomas and 7% of malignant primary bone tumors. Diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) represents the predominant histological type and constitutes over 80% of all cases. PBL may occur at all ages with a typical diagnosis age of 45–60 years and a slight male predominance. Local bone pain, soft tissue edema, palpable mass and pathological fracture are the most common clinical features. Diagnosis of the disease, which is frequently delayed due to its non-specific clinical presentation, is based on the combination of clinical examination and imaging studies and confirmed by combined histopathological and immunohistochemical examination. PBL can develop in any part of the skeleton, although it occurs most commonly in the femur, humerus, tibia, spine and pelvis. The imaging appearance of PBL is highly variable and unspecific. In terms of the cell-of-origin, most cases of primary bone DLBCL (PB-DLBCL), NOS belong to the germinal center B-cell-like subtype and specifically originate from germinal center centrocytes. PB-DLBCL, NOS has been considered a distinct clinical entity based on its particular prognosis, histogenesis, gene expression and mutational profile and miRNA signature. PBL carries a favorable prognosis, especially when treated with combined chemoradiotherapy.

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Primary Bone Diffuse Large B-cell Lymphoma

Cited by 40 publications

References 11 publications

Clinical characterization and outcome of primary bone lymphoma: a retrospective study of 61 Chinese patients

Clinical characterization and outcome of primary bone lymphoma: a retrospective study of 61 Chinese patients

Clinical characteristics and prognostic factors of bone lymphomas: focus on the clinical significance of multifocal bone involvement by primary bone large B-cell lymphomas

Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis

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