Results of a Prospective Study of High-Dose or Conventional Anthracycline-Cyclophosphamide Regimen Plus Radiotherapy for Localized Adult Non-Hodgkin’s Primary Bone Lymphoma

الملخص EN

Background.

Primary bone lymphoma (PBL) is a rare entity that has only been reviewed in one prospective and small retrospective studies, from which it is difficult to establish treatment guidelines.

We prospectively evaluated high-dose or conventional anthracycline-cyclophosphamide dose and radiotherapy for PBL.

Patients and Methods.

The GOELAMS prospective multicenter study (1986–1998) enrolled adults with localized high-grade PBL according to age and performance status (PS).

Patients <60 years received a high-dose CHOP regimen (VCAP) and those ≥60 years a conventional anthracycline-cyclophosphamide regimen (VCEP-bleomycin); all received intrathecal chemotherapy and local radiotherapy.

Results.

Among the 26 patients included (VCAP: 19; VCEP-bleomycin: 7), 39% had poor PS ≥2.

With a median follow-up of 8 years, overall survival, event-free survival, and relapse-free survival were 64%, 62%, and 65%, respectively, with no significant difference between treatment groups.

Poor PS was significantly associated with shorter OS and EFS.

Conclusions.

Our results confirm the efficacy of our age-based therapeutic strategy.

High-doses anthracycline-cyclophosphamide did not improve the outcome.

VCEP-bleomycin is effective and well tolerated for old patients.

The intensification must be considered for patients with PS ≥2, a poor prognostic factor.