蓝色象征Review
TheScientificWorldJOURNAL (2011) 11, 687–696
ISSN 1537-744X; DOI 10.1100/tsw.2011.59
九子夺嫡每个人的下场Plasmablastic Lymphoma: A Systematic
Review
Jorge J. Castillo* and John L. Reagan
The Warren Alpert Medical School of Brown University, Division of Hematology and京酱肉丝的家常做法
铅笔橡皮Oncology, The Miriam Hospital, Providence, RI
E-mail: jcastillo@lifespan
Received December 12, 2010; Revid February 7, 2011, Accepted February 8, 2011; Published March 22, 2011
Plasmablastic lymphoma (PBL) is a very aggressive variant of diffu large B-cell
lymphoma initially described in the oral cavity of HIV-infected individuals. PBL
reprents a diagnostic challenge given its characteristic morphology and lack of CD20
expression, and also a therapeutic challenge, with early respons to therapy, but with
中国最美女人high relap rates and poor prognosis. In recent years, our understanding and clinical
购物城experience with PBL has incread in both HIV-positive and -negative ttings. However,
given its rarity, most of the data available rely on ca reports and ca ries. The main
goal of this article is to systematically review the most recent advances in epidemiology;
pathophysiology; clinical, pathologic, and molecular characteristics; therapy; and
prognosis in patients with PBL. Specific covered topics include new pathological
markers for diagnosis, its association with Epstein-Barr virus, and the need of more
intensive therapies.
KEYWORDS: plasmablastic lymphoma, PBL, HIV, AIDS, chemotherapy
INTRODUCTION
Plasmablastic lymphoma (PBL) is a relatively new clinical entity described as a distinct subtype of
diffu large B-cell lymphoma (DLBCL), characterized by its aggressive nature and plasmacytic
differentiation[1]. In the original report, 15 out 16 patients were infected with HIV and all the patients had
involvement of the oral cavity[2]. In the last decade, veral ca reports and ries have been published,
accounting for no more than 250 cas[3,4]. More recently, however, veral cas of PBL involving
extraoral sites have been reported in immunocompetent individuals[5,6,7,8,9].
PBL remains a diagnostic challenge given its peculiar morphology and an immunohistochemical
profile similar to plasma cell myeloma (PCM). Furthermore, PBL is a therapeutic challenge with a
clinical cour characterized by a high rate of relap and death. It is important to note that there is no
established standard of care for PBL as it is unknown if the outcome of patients with PBL has improved
in the highly active antiretroviral therapy (HAART) era. However, as a better understanding of the
pathophysiology and biology develops, different options are of potential interest for the treatment of
PBL.
The purpo of this review is to summarize, in a comprehensive but conci manner, the existing data
regarding epidemiology, pathogenesis, clinical and pathologic features, diagnostic criteria, therapy, and
*Corresponding author.
©2011 with author.
Published by TheScientificWorld;
687
Castillo and Reagan: Plasmablastic Lymphoma: A Systematic Review
TheScientificWorldJOURNAL (2011) 11, 687–696
prognostic factors on patients with PBL. Plasmablastic microlymphomas, also known as large B-cell
lymphomas arising from human herpesvirus 8 (HHV8)–associated multicentric Castleman dia[10],建档伟业
are a distinct subtype of lymphoma and are beyond the scope of this review.
EPIDEMIOLOGY
PBL is a rare entity, thought to account for approximately 2.6% of all AIDS-related lymphomas
(ARLs)[11], although the exact rate of incidence is not known. Furthermore, the actual incidence of PBL
not associated with HIV infection has not yet been determined. In the largest literature review of 228影字组词
patients with PBL, 157 patients (69%) were HIV-positive and 71 (31%) were HIV-negative[5]. In HIV-
negative patients, approximately a third of the patients have some form of iatrogenic immunosuppression,
most often solid organ transplantation[4]. The remainder of the HIV-negative patients is apparently
immunocompetent; in a recent ca ries from Korea, none of the patients reported showed evidence of
immunosuppression[7].
The majority of patients with PBL are men, particularly the HIV-positive cas, with a mean age at
