Introduction Starting in 1994 a series of four studies of Osteolymphoma (Primary Bone Lymphoma) have been undertaken. These studies were intended to characterise the disease and provide reliable information about treatment outcomes.

Methods Following a pilot study of 17 patients at West-mead hospital, an Australia-wide survey was conducted through the Australasian Radiation Oncology Lymphoma Group (AROLG) and data were published relating to 70 cases from nine institutions. Thereafter a prospective clinical trial was started under the auspices of the Trans-Tasman Radiation Oncology Group (TROG) and is currently accruing satisfactorily. To foster accrual to this trial the International Extranodal Study Group (IELSG) was invited to participate and they indicated they would only do so after a retrospective study of their own databases was undertaken. This retrospective study is also underway.

Results Results so far indicate a highly heterogeneous disease but with some common features, including some previously unnoticed behaviours, particularly the tendency to occur and recur mulitfocally both monostotically and polyostotically. The results are worse than other lymphomas but the use of new combinations of chemotherapy and radiotherapy is being tested and is likely to improve upon the outcomes. After eradicating the disease, there is a significant risk of subsequent fracture related to treatment factors. Orthopaedic surgery still has an important role to play in obtaining sufficient biopsy material without compromising stability, in providing stability where needed prior to radiotherapy and chemotherapy and in the treatment of subsequent fractures.

Conclusions Specialists involved in the treatment of bone tumours are encouraged to become familiar with this world-wide, Australian based line of investigation so that maximum accrual can be achieved

In relation to the conduct of this study, one or more of the authors is in receipt of a research grant from a non-commercial source.