Primary diffuse large B-cell lymphoma of the bone marrow in a frail and elderly patient successfully treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone

TO THE EDITOR: The involvement of bone marrow (BM) in aggressive non-Hodgkin lymphomas (NHLs) usually indicates systemic dissemination. However, although uncommon, extranodal involvement of the BM as an isolated and unique localization of aggressive NHLs [1] such as anaplastic large cell lymphoma [2] or diffuse large B-cell lymphoma (DLBCL) [3-6], has also been reported. In particular, primary DLBCL of the BM is a rare type of extranodal lymphoma with poor prognosis [1, 4]. Approximately 10 cases of primary DLBCL of the BM have been described thus far [3], and few of them have been reported in individuals of very advanced age. Here, we report a case of primary DLBCL of the BM that was successfully treated using rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP chemotherapy; 3-week standard schedule) in a frail 76-year-old woman.