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Bone involvement in young patients with non-Hodgkin's lymphoma: efficacy of
chemotherapy without local radiotherapy
TB Haddy, AM Keenan, ES Jaffe and IT Magrath
Pediatric Branch, National Cancer Institute, Bethesda, MD 20892.
Of 95 young non-Hodgkin's lymphoma patients entered consecutively on the
National Cancer Institute (NCI) Protocol 7704, 26 (27.4%) had involvement
of one or more bones. The mean age of these 26 patients was 16.6 years, and
the male to female ratio was 3.3:1. Tumor histology included
undifferentiated Burkitt's lymphoma in 12, undifferentiated non-Burkitt's
lymphoma in two, undifferentiated, unspecified lymphoma in one, diffuse
large cell lymphoma in three, and lymphoblastic lymphoma in eight patients.
Most had extensive disease; two patients had isolated bone lesions, one had
lesions of two bones without involvement of other tissues, and 23 had
either multiple bone lesions or single bone lesions with involvement of
other tissues. Eight of the 26 patients had bone marrow involvement. Of a
subgroup of 12 patients with jaw disease, 11 had undifferentiated lymphoma
and one had diffuse large cell lymphoma. Only one had primary a jaw tumor,
with two quadrants of the jaw involved. All 26 patients were treated with
chemotherapy; only two received radiotherapy initially for bone lesions.
Predicted survival of the 26 patients at 5 years is 53.2%. The 12 patients
who remain disease free have a mean survival of 62.1 months (range, 22 to
100 months). Our results call into question the role of radiotherapy in the
treatment of bone lesions in non-Hodgkin's lymphoma.
Volume 72,
Issue 4,
pp. 1141-1147,
10/01/1988
Copyright © 1988 by The American Society of Hematology
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