Avtor/Urednik		Proulx, Gary M; El-Agamawi, Ahmed Y; Lee, Jeffrey R; Orner, James B; Czuczman, Myron; McCarthy, Phillip; Bernstein, Zale; Bernstein, Steve
Naslov		Primary non-Hodgkin's lymphomas of bone: treatment and outcome
Prevedeni naslov		Primarni ne-Hodgkinov lymphom kosti: zdravljenje in potek bolezni
Tip		članek
Vir		Radiol Oncol
Vol. in št.		Letnik 34, št. 1
Leto izdaje		2000
Obseg		str. 27-33
Jezik		eng
Abstrakt		Background. This study was performed to assess the characteristics, management and outcome of patients with primary Non-Hodgkin's lymphoma of the bone that were diagnosed and treated at Roswell Park Cancer Institute. Patients and methods. Eighteen patients were presented to us with the criteria, for diagnosis with histopathological and immunohistochemical confirmation, of Non-Hodgkin Lymphoma with adequate bone biopsy between 1970-1996. Twelve patients received combined treatment with anthracycline based chemotherapy and localized radiation, 5 received localized radiation alone and 1 had chemotherapy alone. Results. There were fifteen patients with stage IEA, and three patients were staged IVEA. The histopathological examination revealed 13 patients with intermediate-grade diffuse, large cell, 2 patients were intermediate grade diffuse mixed small and large cells, 2 patients were intermediate grade diffuse small cleaved cell type, and 1 patient had an anaplastic large cell type. Five patients treated with combined treatment and one patient treated with localized radiation alone are without evidence of the disease at a median follow-up of 13 years. Six patients who had combined treatment with radiation and chemotherapy and 3 patients who had radiation alone died from progression of their disease. Two died from other causes, one with combined treatment with radiation and chemotherapy and the other with radiation alone. One patient with combined treatment was disease free at one year but was lost to follow -up. Conclusions. This study suggests that patients presenting with early-stage primary Non-Hodgkin's Lymphoma of bone can be treated with curative intent with the combination treatment of localized radiation and systemic chemotherapy. However, confirmation needs to be verified in larger and prospective studies.
Izvleček		Izhodišča. Z raziskavo smo želeli ugotoviti značilnosti bolnikov s primarnim ne-Hodgkinovim limfomom kosti pa tudi kako smo jih zdravili na Roswelll Park Cancer inštitutu in kakšni so bili rezultati zdravlenja. Bolniki in metode. V letih 1970-1996 smo preiskovali razširjenost bolezni in zdravili 18 bolnikov, ki so jim s kostno biopsijo histopatološko in imunohistokemično potrdili ne-Hodgkinov limfom kosti. 12 bolnikov je prejelo kombinirano kemoterapijo z antraciklini in so bili tudi lokalizirano obsevani, 5 bolnikov smo samo obsevali in 1 je prejel samo kemoterapijo. Rezultati. Ugotovili smo, da je 15 bolnikov imelo bolezenski stadij IEA in 3 bolniki stadij IVEA. Histopatološko pa je 17 od 18 bolnikov imelo limfom srednje stopje malignosti, med njimi 13 bolnikov difuzni velikocelični, 2 difuzni mešani drobno in velikocelični, 2 drobnocelični ter 1 od 18 bolnikov anaplastični velikocelični limfom. Srednja vrednost sledenja bolezni je bila 13 let in 5 bolnikov, ki smo jih kombinirano zdravili ter eden, ki smo ga samo obsevali je še vedno brez znakov bolezni. 6 bolnikov, ki je prejelo kombinirano zdravljenje in 3 bolniki, ki so bili samo obsevani je umrlo. Pri dveh bolnikih je bila druga bolezen vzrok smrti, od njuju je bil eden kombinirano zdravljenjen in drug samo obsevan. O enem bolniku, ki je bil v popolni remisiji, po letu dni nismo več uspeli dobiti podatkov. Zaključki. Raziskava nakazuje, da lahko bolnike z zgodnjimi stadiji primarnega ne-Hodgkinovega limfoma kosti uspešno zdravimo s kombinacijo kemoterapije in lokaliziranega obsevanja. Seveda pa so za dokončno ugotovitev potrebne večje randomizirane raziskave.
Deskriptorji		LYMPHOMA, NON-HODGKIN'S BONE NEOPLASMS ANTHRACYCLINES TREATMENT OUTCOME