title: Primary bone marrow diffuse large B cell lymphoma: a case series and review.
abstract: Diffuse large cell lymphoma involving bone marrow is not uncommon, but primary, de novo, bone marrow diffuse large B cell lymphoma (DLBCL) is rare. To understand the clinical features and outcomes of this distinct entity, we collected 12 cases in 5 years from a single-center database. They accounted for 1.16% of lymphoma, or 2.65% of diffuse large B cell lymphoma. Nine cases presented with fever of unknown origin. Lactate dehydrogenase levels were elevated in all but one case. Nine cases belonged to the high-risk group according to their international prognosis indexes (score 4 or 5). Four patients received no chemotherapy, all of whom died within 1 month. Four patients received cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP)-like chemotherapy, and their median survival was 13 months. Finally, four patients received rituximab 375 mg/m(2) in addition to CHOP-like chemotherapy. All of them had complete remission and three are still alive without relapse. We concluded that primary bone marrow DLBCL is a rare but distinctive subtype of lymphoma. The prognosis for this entity is poor but rituximab-based treatment is promising for improving its outcomes.
authors.affiliation: Division of Hematology-Oncology, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, Taiwan, Republic of China.
authors.forename: Hung
authors.initials: H
authors.lastname: Chang
authors.forename: Yu-Shin
authors.initials: YS
authors.lastname: Hung
authors.forename: Tung-Liang
authors.initials: TL
authors.lastname: Lin
authors.forename: Po-Nan
authors.initials: PN
authors.lastname: Wang
authors.forename: Ming-Chung
authors.initials: MC
authors.lastname: Kuo
authors.forename: Tzung-Chih
authors.initials: TC
authors.lastname: Tang
authors.forename: Jin-Hou
authors.initials: JH
authors.lastname: Wu
authors.forename: Po
authors.initials: P
authors.lastname: Dunn
authors.forename: Lee-Yung
authors.initials: LY
authors.lastname: Shih
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D001853:Bone Marrow / Q000473:pathology*; D003520:Cyclophosphamide; D016208:Databases, Factual; D004317:Doxorubicin; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011241:Prednisone; D011379:Prognosis; D000069283:Rituximab; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone