Blood Res.
2020 Mar;55(1):49-56. 10.5045/br.2020.55.1.49.
HIV-negative plasmablastic lymphoma: report of 8 cases and a comprehensive review of 394 published cases
- Affiliations
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- 1Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, China. zhouhui@hnca.org.cn
- 2Department of Lymphoma and Hematology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
- 3Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
- 4Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
- 5Institute of Pathology, Fudan University, Shanghai, China.
- 6Department of Radiotherapy, Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, China.
- 7Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.
- 8Department of Oncology, Cancer Center of the Second Xiangya Hospital, Central South University, Changsha, China.
- KMID: 2472008
- DOI: http://doi.org/10.5045/br.2020.55.1.49
Abstract
- BACKGROUND
Human immunodeficiency virus (HIV)-negative plasmablastic lymphoma (PBL) is a rare entity of diffuse large B-cell lymphoma (DLBCL). The clinicopathological features of and optimal treatment for HIV-negative PBL remain largely unknown.
METHODS
To gain insight into this distinct lymphoma, we summarized the clinicopathologic characteristics of 8 unpublished HIV-negative PBLs and performed a comprehensive review of 394 published cases.
RESULTS
Of the 8 unpublished PBLs, the median patient age was 53.0 years. Four patients presented with stage IV disease. All 8 patients showed a plasma cell-like immunophenotype. Of the six patients who received anthracycline-based chemotherapy, including two who received bortezomib, three patients achieved a continuous complete response, two patients died due to disease progression, and one patient was lost to follow-up. The other two patients achieved continuous complete response after receiving chemotherapy combined with radiotherapy and surgery. Of the 402 patients, the majority were male, with a mean age of 58.0 years. EBV infection was detected in 55.7% of the patients. The median survival times of the patients who received CHOP or CHOP-like regimens and intensive regimens were not reached and 23.0 months, respectively, and the intensive regimen did not improve the survival outcome (P=0.981). Multivariate analysis showed that EBER remained the only independent factor affecting overall survival (OS).
CONCLUSION
HIV-negative PBL is a distinct entity with a predilection for elderly and immunosuppressed individuals. Intensive chemotherapy had no apparent survival benefits over the CHOP regimen in terms of OS; the prognosis of this disease is poor with current chemotherapy methods, and treatment remains a challenge.
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