130021 吉林 长春,吉林大学第一医院肿瘤中心血液科Department of Hematology, Cancer Center, First Hospital of Jilin University, Changchun, Jilin Province, 130021, China
Received:18 October 2017,
Published:28 February 2018
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Yiqi DAI, Shunan WANG, Wei GUO, et al. Bortezomib in treatment of HIV-negative plasmablastic lymphoma: report of 3 cases and literature review[J]. Journal of Third Military Medical University, 2018, 40(4): 334-339.
Yiqi DAI, Shunan WANG, Wei GUO, et al. Bortezomib in treatment of HIV-negative plasmablastic lymphoma: report of 3 cases and literature review[J]. Journal of Third Military Medical University, 2018, 40(4): 334-339. DOI: 10.16016/j.1000-5404.201710120.
目的
2
提高对人免疫缺陷病毒(human immunodeficiency virus,HIV)阴性浆母细胞淋巴瘤(plasmablastic lymphoma,PBL)的临床特征、治疗及预后的认识。
方法
2
回顾性分析吉林大学第一医院肿瘤中心血液科2015-2016年收治的应用硼替佐米治疗的3例HIV阴性PBL患者的临床资料,分析其临床特征及转归。
结果
2
① 3例HIV阴性PBL患者均为男性,年龄分别为42、43、35岁;其中2例以腹部症状起病,1例以淋巴结肿大起病;均无导致免疫功能低下的疾病或状态。② 2例有结外受累,1例有骨髓受累;根据淋巴瘤Ann Arbor分期分别为ⅠA、ⅢA、ⅣB期。③病理:均表现弥漫大B细胞淋巴瘤的形态学特点;具有典型的浆细胞表型;Ki-67指数分别为80%、70%、40%。④治疗:3例均采用了以硼替佐米为基础的联合化疗方案,1例完全缓解(clinical complete response,CR),2例部分缓解(partly remission
PR),无进展生存期(progression-free survival
PFS)分别为1、6、10个月,总生存期(overall survival
OS)分别为5个月、7个月、未获得。
结论
2
该组人免疫缺陷病毒阴性浆母细胞淋巴瘤患者以中青年为主,疾病呈高侵袭性;临床分期为晚期及Ki-67高的患者预后差;硼替佐米用于治疗浆母细胞淋巴瘤需要临床进一步观察。
Objective
2
To better understand the clinical features
treatment and prognosis of HIV-negative plasmablastic lymphoma (PBL).
Methods
2
The clinical data were reviewed for 3 cases of HIV-negative PBL treated with bortezomib in our department between January
2015 and December
2016. The clinical features and outcomes of the patients were analyzed retrospectively.
Results
2
All these 3 patients were male and aged 42
43
and 35 years. Two of the patients presented with gastrointestinal discomfort and the other patient had lymphadenopathy as the initial symptom. None of them had underlying immunosuppressive state. Extra-nodular involvement was found in 2 patients and bone marrow involvement in the other
and they were in stage Ⅳ
stage Ⅲ
and stage Ⅰ according to Ann Arbor Staging. Pathological examination revealed morphological features of diffuse large B cell lymphoma and typical immunophenotypic characteristics of plasma cells in all the 3 patients
and their Ki-67 index was 80%
70%
and 40%. All the patients received bortezomib-based chemotherapy
and complete response was achieved in 1 patient and partial responses in the other 2. The progression-free survival of the 3 patients was 1
6 and 10 months with overall survival of 5
7 and over 22 months
respectively.
Conclusion
2
The patients with HIV-negative PBL are mainly at the middle age upon disease onset. HIV-negative PBL is highly aggressive
and the patients in advanced stage or with a high Ki-67 index at the diagnosis often have a poor prognosis. The efficacy of bortezomib for treatment of PBL still needs further investigation.
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