Prognostic implication of a focal lesion of bone marrow in diffuse large B cell lymphosarcoma

Aim. To study prognostic implications of a focal mature cell lesion of the bone marrow (BM) in patients with diffuse large B cell lymphosarcoma (DBLCL). Material and methods. 54 patients with histologically confirmed DBLCL were given first-line CHOP and CHOP-like courses from 1996 to 2003. B-cell nature of the tumor was confirmed immunohistochemically, immunophenotypically and with flow fluorimetry. Results. In debute of the disease 16 patients had local involvement of the lymph organs (stage I-II by Enn-Arbor), 21 patients - generalized disease (stage III-IV) and 17 patients - involvement of non-lymphatic organs. Overall 3-year survival in first-line therapy in mature cell lesion of BM was 23%, without it - 0%. One-year event-free survival was 34 and 0%, respectively. Conclusion. The presence of a focal mature cell lesion of BM in DBLCL patients influences the prognosis. Regarding high frequency of transformation of mature cell lymphoproliferative diseases in DBLCL, focal lesion of BM is an indirect sign of a secondary nature of the disease.