Non-Hodgkin's lymphoma with bone involvement: a single center experience with 18 patients/ Kemik tutulumlu Hodgkin disi lenfoma: onsekiz hasta ile tek merkez deneyimi

Objective: Non-Hodgkin's lymphoma (NHL) of bone is a rare entity. The most common histological subtype is diffuse large B cell lymphoma (DLBCL). The major presenting symptoms are soft tissue swelling, bone pain and pathological fracture. Treatment options are chemotherapy, radiotherapy, surgery, or a combination of these modalities. Materials and Methods: We retrospectively analyzed the 18 patients (11 females, 7 males) with NHL of bone who were diagnosed and treated between 1995-2005. The median age was 56.5 years. The median duration of symptoms was 4.5 months. The bone pain was the first symptom in all patients. Tru-cut biopsy was performed for diagnosis in most of the cases. Diagnosis in five patients (27.8%) required open biopsy. Results: DLBCL (77.8%) was the most common histological type among all patients. Other histological subtypes were anaplastic large cell lymphoma (11.1%), Burkitt-like lymphoma (5.6%) and marginal zone lymphoma (5.6%). According to Ann Arbor staging system, 44.4% of patients were Stage I, 11.1% were Stage II and 44.4% were Stage IV. Bone marrow involvement was determined in four patients (22.2%). All patients except one were treated with anthracycline-containing regimens and eight patients (44.4%) received rituximab combination with chemotherapy. Radiation therapy was performed as the first-line therapy in 9 (50%) patients. The median follow-up was 37 months (range, 2-124 months). Among the 17 patients who achieved complete remission, five (27.8%) relapsed. All patients were still alive. The five-year relapse-free survival was 73.5%. Conclusion: The treatment of bone lymphoma can be planned according to the stage and location of the disease. Although we had a relatively low number of patients, it could be concluded that whether or not radiation therapy is performed, rituximab in combination with systemic chemotherapy has been proven beneficial on survival. (Turk J Hematol 2010; 27: 29-33) Key words: Non-Hodgkin's lymphoma, bone, lymphoma Amac: Kemik lenfomalari oldukca nadirdir ve en sik gorulen histolojik alt tip diffuz buyuk B-hucreli (DBBHL) non-Hodgkin lenfomadir (NHL). Hastalar cogunlukla kemik ya da yumusak dokuda sislik, kemik agrisi ve patolojik kirik yakinmalari ile basvururlar. Tedavi genellikle cerrahi, radyoterapi, kemoterapi veya bunlarin kombinasyonu seklindedir. Yontem ve Gerecler: Bu calismada, merkezimizde 1995 ve 2005 yillari arasinda tani alan 18 primer kemik NHL'li (11 kadin, 7 erkek) hasta retrospektif ola