Spinal manifestations of diffuse large B-cell lymphoma

IF 4.7 1区医学 Q1 CLINICAL NEUROLOGY Spine Journal Pub Date : 2025-11-01 Epub Date: 2025-03-26 DOI:10.1016/j.spinee.2025.03.025

Aymeric Amelot MD, PhD , Louis-Marie Terrier MD, PhD , Gabrielle Cognacq BSc, BMBCh , Lotfi Benboubker MD , Christophe Destrieux MD, PhD , Ilyess Zemmoura MD, PhD , Patrick Francois MD, PhD , Mourad Aggad MD , Bertrand Mathon MD, PhD

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Abstract

BACKGROUND CONTEXT

Spinal diffuse large B-cell lymphoma (DLBCL) can be divided into 2 categories: primary non-Hodgkin's lymphoma (PNHL) and metastases from disseminated DLBCL. Prognostic factors of spinal DLBCL metastases seem to differ from those of other spine metastases and PNHL, although the data in the literature remains scarce.

PURPOSE

This study aims at investigating prognostic factors associated with overall survival (OS) in patients with spine DLBCL metastases.

STUDY DESIGN

A retrospective study.

PATIENT SAMPLE

A total of 371 patients were treated for DLBCL, including 62 cases of spine DLBCL metastases.

OUTCOME MEASURES

Patient demographics were collected with survival.

METHODS

This study is based on consecutive prospective population of, between January 2015 and 2019.

RESULTS

The median age of the 371 patients was 68.4 years (range 19.1–94.0 years) and 58.8% were males (218 patients). The median OS for our whole series was 82.06 months (SD 11.2.), and 53.0 months (SD 41.2, p=.622) for the 62 patients with spine DLBCL metastases. The mean duration between DLBCL diagnosis and development of spine metastases (SpM) was 9.0 months (range 0.0-160.8 months). Cox multivariate proportional hazard model identified ECOG <2 [HR: 0.O59, 95 % CI 0.019–0.075; p<.0001], age <40 years [HR: 0.206, 95 % CI 0.08–0.506; p=.001], and IPI score ≤2 [HR: 0.472, 95 % CI 0.03–2.104; p=.001] as predictors of longer survival. In contrast, age >80 years [HR: 2.198, 95 % CI 1.481–3.261; p<.0001], IPI score >4 [HR: 3.232, 95 % CI 1.765–4.654; p=.008] were independent poor prognostic factors of survival.

CONCLUSION

Spinal lesions in DLBCL are metastatic in nature whereas spine PNHL, similar to multiple myeloma, appears to be a primary spinal malignancy. The main prognostic factors of DLBCL spine metastases are those of the primary disease itself, and should be considered before spinal surgery.

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弥漫性大b细胞淋巴瘤的脊柱表现。

背景情况：脊柱弥漫大B细胞淋巴瘤（DLBCL）可分为两类：原发性非霍奇金淋巴瘤（PNHL）和播散性DLBCL转移瘤。脊柱DLBCL转移瘤的预后因素似乎与其他脊柱转移瘤和PNHL的预后因素不同，但文献数据仍然很少。研究设计：回顾性研究患者样本：371例接受过DLBCL治疗的患者，其中62例为脊柱DLBCL转移瘤结局测量：收集患者的人口统计学资料，并将其与总生存率（OS）进行比较：收集患者人口统计学资料和生存率：本研究基于 2015 年 1 月至 2019 年期间的连续前瞻性人群：371例患者的中位年龄为68.4岁（19.1岁至94.0岁），58.8%为男性（218例患者）。整个系列的中位OS为82.06个月（SD 11.2），62例脊柱DLBCL转移患者的中位OS为53.0个月（SD 41.2，P=0.622）。从诊断为DLBCL到发生脊柱转移（SpM）的平均时间为9.0个月（0.0-160.8个月）。Cox多变量比例危险模型发现，ECOG 80岁[HR：2.198，95 % CI 1.481-3.261; p < 0.0001]、IPI评分>4[HR：3.232，95 % CI 1.765-4.654; p =0.008]是独立的不良预后生存因素：结论：DLBCL的脊柱病变具有转移性，而脊柱PNHL与多发性骨髓瘤类似，似乎是一种原发性脊柱恶性肿瘤。DLBCL脊柱转移的主要预后因素是原发疾病本身的预后因素，脊柱手术前应考虑这些因素。

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来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.