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Clinical features and prognostic factors of primary bone marrow lymphoma

Authors Wang G, Chang Y, Wu X, Li X, Li L, Zhang L, Fu X, Sun Z, Zhang X, Zhang M

Received 14 September 2018

Accepted for publication 23 January 2019

Published 29 March 2019 Volume 2019:11 Pages 2553—2563


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Beicheng Sun

Gangjian Wang, Yu Chang, Xiaolong Wu, Xin Li, Ling Li, Lei Zhang, Xiaorui Fu, Zhenchang Sun, Xudong Zhang, Mingzh Zhang

Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Background: Primary bone marrow lymphoma (PBML) is a very uncommon neoplasm originally arising in the bone marrow system, and the most common pathological type is diffuse large B-cell lymphoma.
Patients and methods: To describe the clinical characteristics of PBML and evaluate the risk factors related to prognosis, we recruited and studied 66 patients from our center and the current published literature. Various symptoms are present at the onset of PBML, the most important of which is cytopenia, followed by fever. Forty-seven of these patients were included in our analysis.
Results: Univariate analysis suggested that B symptoms (P=0.024), a low serum platelet level (<75×109/L; P=0.032), an elevated serum LDH level (P=0.039), and not achieving a complete response (CR) following initial therapy (P=0.007) are associated with worse outcomes. Multivariate analysis showed that only a low serum platelet level (<75×109/L), B symptoms, and not achieving a CR following initial therapy are independent factors for prognosis. In addition, intensive regimens appear to be beneficial for prognosis.
Conclusion: PBML is a lymphoma with special clinical features, and its recognition is important for establishing a definitive prognosis model and searching for appropriate therapy.

Keywords: diffuse large B-cell lymphoma, primary bone marrow lymphoma, bone marrow, B symptoms, cytopenia

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