Non-Hodgkin's lymphoma presenting with spinal involvement: the Sheffield Lymphoma Group experience (1970-2000)

Spinal non-Hodgkin's lymphoma is rare. We retrospectively reviewed the clin ical and histopathologic records of 39 consecutive patients referred to the Sheffield Lymphoma Group from 1970 to 2000 and analysed the prognostic dif ferences between localised (stage I, and II,) and secondary (stage III and IV) spinal non-Hodgkin's lymphoma (S-NHL) patients. Forty-five percent of a ll patients were over 60 years old. More patients were male (58%); presente d with stage I-E and IIE (63%), mostly of intermediate/high grade histology (74%); over a third had 'B' symptoms; nearly a third(ll patients) were par aplegic and 14 had sphincter dysfunction at diagnosis. The overall survival of all patients was 39% at 5 years (median 24.7 months), whilst that of lo calised S-NHL was 51% (median 89.7 months). Univariate analysis showed bett er survival for patients with good mobility status at presentation (p <0.01 ) and complete response to initial treatment (p <0.001). In primary S-NHL, histology (p <0.05) significantly influenced overall survival, in conclusio n, disease is frequently locally advanced at presentation with aggressive h istologic grade: thorough staging should always be performed to exclude wid espread disease. Good mobility status predicts for good survival outcome. O ptimal treatment is still uncertain.