JCHOR
Journal of Current Hematology & Oncology Research

The Journal of Current Hematology & Oncology Research regularly publishes internationally qualified research in hematology and oncology within the current scholarly knowledge.

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Original Article
Clinical characteristics, treatment outcomes, and survival of patients with primary bone diffuse large b-cell lymphoma: a single-center retrospective analysis
Abstract
Aims: Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is a rare extranodal lymphoma with generally favorable outcomes following anthracycline-based immunochemotherapy. However, the prognostic impact of disease distribution remains poorly defined, and only a limited number of studies have reported treatment outcomes separately for patients with unifocal (UF) and multifocal (MF) disease. This study aimed to evaluate the clinical characteristics, treatment outcomes, survival, and safety of PB-DLBCL, with particular emphasis on differences between UF and MF disease.
Methods: This retrospective single-center study included 13 consecutive adult patients with histologically confirmed PB-DLBCL diagnosed between 2010 and 2025. Patients were classified as UF (n=9) or MF (n=4) according to the number of involved bone sites. Clinical characteristics, treatment response, survival outcomes, and treatment-related adverse events were analyzed.
Results: The median age was 59 years (range, 18–78), and localized bone pain was the most common presenting symptom (92.3%). Patients with MF disease tended to present with more adverse clinical features, including bulky lesions, elevated lactate dehydrogenase levels, larger lesions, and poorer performance status. Complete and partial responses were achieved in 9 (69.2%) and 1 (7.7%) patient, respectively, yielding an overall response rate of 76.9%. The overall response rate was 100% in the UF group compared with 25% in the MF group (p=0.014). The median overall survival was 88.15 months, with a 2-year overall survival rate of 91.7%; the corresponding 2-year overall survival rates were 100% and 66.7% in the UF and MF groups, respectively. Hematologic toxicities were the most common adverse events, while grade 3–4 toxicities were infrequent and treatment was generally well tolerated.
Conclusion: Anthracycline-based immunochemotherapy provides excellent outcomes for most patients with PB-DLBCL. However, MF disease is associated with substantially inferior treatment response and survival compared with UF disease. Despite the limited sample size, our findings add to the scarce literature evaluating UF and MF disease separately and further support disease distribution as an important prognostic factor in PB-DLBCL. Future multicenter studies are warranted to validate these findings and optimize treatment strategies for patients with MF disease.

Keywords : Primary bone lymphoma, diffuse large B-cell lymphoma, treatment outcome

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Ethical Statement

<p>This study was approved by the Non-interventional Clinical Researches Ethics Committee of Marmara University Faculty of Medicine (Date: 27.03.2026, Decision No: 09.2026.26-0369).</p>

Informed Consent

<p>This retrospective study used pre-existing anonymized patient data. No additional intervention was performed, and there was no direct patient contact. The study was approved by the Ethics Committee, and the requirement for written informed consent was waived by the ethics committee.</p>

Author Contributions

<p>Concept: AFY, IA; Design: MUM, TT; Control: ES, S&Ouml;, FA; Resources: TE, AB; Materials: RB&Ouml;, CG; Data Collection and/or Processing: FT, AFY; Analysis and/or Interpretation: AFY, IA; Literature Review: TT, FA; Writing the Article: AFY; Critical Review: AFY, MUM, TE, AB, RB&Ouml;, CG, S&Ouml;, FT, FA, ES, TT, IA.</p>

Conflict of Interest

<p>The authors declare no conflicts of interest related to this study.</p>

Financial Disclosure

<p>The authors received no financial support for the conduct or publication of this research.</p>


1. Kanavos T, Birbas E, Papoudou-Bai A, et al. Primary bone lymphoma: a review of the literature with emphasis on histopathology and histogenesis. Diseases. 2023;11(1):42. doi:10.3390/diseases11010042
2. Jo VY, Fletcher CD. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology. 2014;46(2):95-104. doi:10.1097/PAT.0000000000000050
3. Ramadan KM, Shenkier T, Sehn LH, Gascoyne RD, Connors JM. A clinicopathological retrospective study of 131 patients with primary bone lymphoma: a population-based study of successively treated cohorts from the British Columbia Cancer Agency. Ann Oncol. 2007; 18(1):129-135. doi:10.1093/annonc/mdl329
4. Stein ME, Kuten A, Gez E, et al. Primary lymphoma of bone-a retrospective study. Experience at the Northern Israel Oncology Center (1979-2000). Oncology. 2003;64(4):322-327. doi:10.1159/000070288
5. Li J, Li X, Gao T, Zhou C, Guo Q, Liu D. Primary diffuse large B-cell lymphoma of bone in adults: a SEER population-based study. Medicine (Baltimore). 2024;103(43):e40071. doi:10.1097/MD.0000000000040071
6. Kim SY, Shin DY, Lee SS, et al. Clinical characteristics and outcomes of primary bone lymphoma in Korea. Korean J Hematol. 2012;47(3):213-218. doi:10.5045/kjh.2012.47.3.213
7. Rezazadeh A, Szabo A, Khurana A, et al. Outcomes of limited stage primary bone diffuse large B-cell lymphoma in the rituximab era: a multicenter, retrospective study. Haematologica. 2024;109(5):1439-1444. doi:10.3324/haematol.2023.283210
8. Pfreundschuh M, Schubert J, Ziepert M, et al. Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60). Lancet Oncol. 2008;9(2):105-116. doi:10.1016/S1470-2045(08)70002-0
9. International Non-Hodgkin’s Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med. 1993;329(14):987-994. doi:10.1056/NEJM199309303291402
10. Cheson BD, Pfistner B, Juweid ME, et al; International Harmonization Project on Lymphoma. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579-586. doi:10.1200/JCO.2006.09.2403
11. Ayesh Haj Yousef MH, Audat Z, Al-Shorafat DM, Al-Khatib S, Daoud AK. Primary diffuse large B cell lymphoma of bone: a single-center experience. J Blood Med. 2022;13:143-149. doi:10.2147/JBM.S350655
12. Wu C, Zhang Y, Yang F, et al. A comprehensive analysis of B symptoms reveals prognosis and heterogeneity across different sites of diffuse large B-cell lymphoma. Ann Hematol. 2025;104(11):5829-5840. doi:10.1007/s00277-025-06579-5
13. Berhan A, Almaw A, Damtie S, Solomon Y. Diffuse large B cell lymphoma (DLBCL): epidemiology, pathophysiology, risk stratification, advancement in diagnostic approaches and prospects: narrative review. Discov Oncol. 2025;16(1):184. doi:10.1007/s12672-025-01958-w
14. Cai L, Stauder MC, Zhang YJ, et al. Early-stage primary bone lymphoma: a retrospective, multicenter Rare Cancer Network (RCN) study. Int J Radiat Oncol Biol Phys. 2012;83(1):284-291. doi:10.1016/j.ijrobp.2011.06.1976
15. Bruno Ventre M, Ferreri AJ, Gospodarowicz M, et al; International Extranodal Lymphoma Study Group. Clinical features, management, and prognosis of an international series of 161 patients with limited-stage diffuse large B-cell lymphoma of the bone (the IELSG-14 study). Oncologist. 2014;19(3):291-298. doi:10.1634/theoncologist.2013-0249
16. Sharma A, Ahmed R, Agrawal N, et al. Primary bone lymphoma: a 13 year retrospective institutional analysis in the chemo-immunotherapy era. Indian J Hematol Blood Transfus. 2021;37(2):240-248. doi:10.1007/s12288-020-01327-3
17. Demircay E, Hornicek FJ Jr, Mankin HJ, Degroot H 3rd. Malignant lymphoma of bone: a review of 119 patients. Clin Orthop Relat Res. 2013;471(8):2684-2690. doi:10.1007/s11999-013-2991-x
18. Zhang X, Zhu J, Song Y, Ping L, Zheng W. Clinical characterization and outcome of primary bone lymphoma: a retrospective study of 61 Chinese patients. Sci Rep. 2016;6:28834. doi:10.1038/srep28834
19. Wu H, Bui MM, Leston DG, et al. Clinical characteristics and prognostic factors of bone lymphomas: focus on the clinical significance of multifocal bone involvement by primary bone large B-cell lymphomas. BMC Cancer. 2014;14:900. doi:10.1186/1471-2407-14-900
20. Zinzani PL, Carrillo G, Ascani S, et al. Primary bone lymphoma: experience with 52 patients. Haematologica. 2003;88(3):280-285.
21. Choi YW, Jeong SH, Ahn MS, et al. Patterns of neutropenia and risk factors for febrile neutropenia of diffuse large B-cell lymphoma patients treated with rituximab-CHOP. J Korean Med Sci. 2014;29(11):1493-1500. doi:10.3346/jkms.2014.29.11.1493
22. Zheng W, Chen Z, Zhu S, et al. Incidence and risk factors for febrile neutropenia of patients with diffuse large B-cell lymphoma receiving R-CHOP-21 in China. Support Care Cancer. 2023;32(1):43. doi:10.1007/s00520-023-08250-z
Article available in :
Volume 4, Issue 4, 2026
Page : 152-158
https://doi.org/10.51271/JCHOR-0100
Article Information
Received : 20 Jul 2026
Accepted : 17 Sep 2026
Published : 13 Nov 2026
Corresponding Author :

Asu Fergün Yılmaz: Department of Hematology, Faculty of Medicine, Marmara University, İstanbul, Turkiye

[email protected]
Citation : Yılmaz AF, Uluköylü Mengüç M, Ercan T, et al. Clinical characteristics, treatment outcomes, and survival of primary bone diffuse large B-cell lymphoma: a descriptive single-center retrospective study. J Curr Hematol Oncol Res. 2026;4(4):152-158. doi:10.51271/JCHOR-0100

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