{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:53:52Z","timestamp":1791618832789,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T00:00:00Z","timestamp":1531094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009096","name":"Taiwan Clinical Oncology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009096","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Primary bone marrow lymphoma (PBML) represents non\u2010Hodgkin lymphoma (NHL) that primarily arises in the bone marrow (BM) without lymphadenopathy. This condition has various definitions and can be masked by prolonged fever, leading to delayed diagnosis. We aimed to identify clinical features and risk indicators of PBML. We enrolled 269 adults with fever of unknown origin (FUO) who underwent a BM study for potential PBML. Thirty patients were diagnosed with PBML (26 and 4 patients in the training and validation cohort, respectively), and 20 patients (67%) showed initial manifestation of hemophagocytic lymphohistiocytosis (HLH). Among PBML patients in the training cohort, their median overall survival is short (8\u00a0days), with pneumonia being the most common direct cause of early mortality, followed by life\u2010threatening HLH. Despite extremely poor prognoses, some B\u2010cell PBML patients who survived 30\u00a0days after BM studies achieved long\u2010term survival with rituximab\u2010based treatment. To assist general practitioners in early PBML diagnosis when approaching adults with na\u00efve FUO, we identified several risk indicators, including elevated serum alkaline\u2010phosphate levels, lowered serum immunoglobulin\u2010G levels, cytopenia in \u22652 lineages, and peripheral blood leukoerythroblastosis. Our recently published scoring system, which can predict hematological BM disease in FUO adults, showed excellent ability in recognizing PBML early, with high sensitivity and specificity. We conclude that PBML is a specific \u201cclinical\u201d phenotype of NHL; moreover, we have identified diagnostic clues for early identification of FUO adults with underlying PBML, which should be considered a hematological emergency once suspected in any adult with FUO.<\/jats:p>","DOI":"10.1002\/cam4.1669","type":"journal-article","created":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T12:01:35Z","timestamp":1531137695000},"page":"3713-3721","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Primary bone marrow lymphoma: A hematological emergency in adults with fever of unknown origin"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0681-0998","authenticated-orcid":false,"given":"Hao\u2010Yuan","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Fen","family":"Yang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzeon\u2010Jye","family":"Chiou","sequence":"additional","affiliation":[{"name":"Faculty of Medicine School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Division of Transfusion Medicine Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyh\u2010Pyng","family":"Gau","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Youh","family":"Tsai","sequence":"additional","affiliation":[{"name":"Faculty of Medicine School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Division of Allergy, Immunology, and Rheumatology Department of Medicine Taipei Veterans General Hospital  Taipei 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