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HEMATOLOGY / CLINICAL RESEARCH
Clinicopathologic characteristics, therapeutic modalities and survival outcomes of plasmablastic lymphoma: A real-world study
1
Department of Hematology, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi’an, Shaanxi, China
2
Department of Hematology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi’an, Shaanxi, China
3
National Clinical Research Center for Hematological Diseases of China, Shaanxi Branch Center, Clinical Research Center for Hematologic Disease of Shaanxi Province, China
4
Office of Drug Clinical Trial Institution, Xi’an Chest Hospital, Xi’an, Shaanxi, China
Submission date: 2021-09-07
Final revision date: 2021-12-12
Acceptance date: 2021-12-13
Online publication date: 2021-12-18
Publication date: 2024-12-31
Arch Med Sci 2024;20(6):1874-1886
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Plasmablastic lymphoma (PBL), an extremely rare subtype of B-cell non-Hodgkin lymphoma (NHL), is characterized by aggressiveness, rapid progression and a bleak prognosis. Neither a standardized regimen nor a consensus for PBL treatment has been established.
Material and methods:
We retrospectively analyzed the clinicopathologic characteristics, therapeutic modalities and survival outcomes of 418 patients registered in the Surveillance, Epidemiology, and End Results (SEER) database from 2008 to 2016 and 21 (19 treated) patients in our institution. Kaplan-Meier survival curves and the log-rank test for overall survival (OS) and disease-specific survival (DSS) were performed to compare each variable. Variables with statistical significance in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors.
Results:
In the patient cohort from the SEER database, PBL has a striking male predilection. The median OS for all PBL patients was 17 months. The 1-year, 3-year and 5-year OS rates were 54.4%, 40.4% and 37.2% respectively. Patients who suffered from previous malignancy had a significant survival disadvantage compared to those without previous cancer. Patients with a higher Ann Arbor stage at diagnosis were at higher risk of death than those with a lower stage. Chemotherapy alone or chemotherapy combined with radiotherapy could significantly reduce the risk of death and extend the patients’ survival, yielding a HR of 0.209 (95% CI: 0.152–0.288) and 0.187 (95% CI: 0.089–0.394), respectively. Radiation alone seemed useless. All patients from our institution were HIV-negative. The main therapeutic regimens were CHOP or CHOPE, DA-EPOCH, DHAP and ESHAP. A complete response (CR) was achieved in only 3 patients, while a partial response was achieved in 10 patients. The median OS was 7 months. Fourteen patients later died due to disease progression.
Conclusions:
Previous malignancy history, Ann Arbor stage and therapeutic modality were independent prognostic factors. Bortezomib combined with DA-EPOCH may serve as an effective regimen for PBL. The optimal therapeutic modality necessitates further exploration.
Plasmablastic lymphoma (PBL), an extremely rare subtype of B-cell non-Hodgkin lymphoma (NHL), is characterized by aggressiveness, rapid progression and a bleak prognosis. Neither a standardized regimen nor a consensus for PBL treatment has been established.
Material and methods:
We retrospectively analyzed the clinicopathologic characteristics, therapeutic modalities and survival outcomes of 418 patients registered in the Surveillance, Epidemiology, and End Results (SEER) database from 2008 to 2016 and 21 (19 treated) patients in our institution. Kaplan-Meier survival curves and the log-rank test for overall survival (OS) and disease-specific survival (DSS) were performed to compare each variable. Variables with statistical significance in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors.
Results:
In the patient cohort from the SEER database, PBL has a striking male predilection. The median OS for all PBL patients was 17 months. The 1-year, 3-year and 5-year OS rates were 54.4%, 40.4% and 37.2% respectively. Patients who suffered from previous malignancy had a significant survival disadvantage compared to those without previous cancer. Patients with a higher Ann Arbor stage at diagnosis were at higher risk of death than those with a lower stage. Chemotherapy alone or chemotherapy combined with radiotherapy could significantly reduce the risk of death and extend the patients’ survival, yielding a HR of 0.209 (95% CI: 0.152–0.288) and 0.187 (95% CI: 0.089–0.394), respectively. Radiation alone seemed useless. All patients from our institution were HIV-negative. The main therapeutic regimens were CHOP or CHOPE, DA-EPOCH, DHAP and ESHAP. A complete response (CR) was achieved in only 3 patients, while a partial response was achieved in 10 patients. The median OS was 7 months. Fourteen patients later died due to disease progression.
Conclusions:
Previous malignancy history, Ann Arbor stage and therapeutic modality were independent prognostic factors. Bortezomib combined with DA-EPOCH may serve as an effective regimen for PBL. The optimal therapeutic modality necessitates further exploration.
REFERENCES (38)
1.
Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127: 2375-90.
2.
Grimm KE, O’Malley DP. Aggressive B cell lymphomas in the 2017 revised WHO classification of tumors of hematopoietic and lymphoid tissues. Ann Diagn Pathol 2019; 38: 6-10.
3.
Montes-Moreno S, Montalbán C, Piris MA. Large B-cell lymphomas with plasmablastic differentiation: a biological and therapeutic challenge. Leuk Lymphoma 2012; 53: 185-94.
4.
Chang CC, Zhou X, Taylor JJ, et al. Genomic profiling of plasmablastic lymphoma using array comparative genomic hybridization (aCGH): revealing significant overlapping genomic lesions with diffuse large B-cell lymphoma. J Hematol Oncol 2009; 2: 47.
5.
Morscio J, Dierickx D, Nijs J, et al. Clinicopathologic comparison of plasmablastic lymphoma in HIV-positive, immunocompetent, and posttransplant patients: single-center series of 25 cases and meta-analysis of 277 reported cases. Am J Surg Pathol 2014; 38: 875-86.
6.
Castillo J, Pantanowitz L, Dezube BJ. HIV-associated plasmablastic lymphoma: lessons learned from 112 published cases. Am J Hematol 2008; 83: 804-9.
7.
Liu M, Liu B, Liu B, et al. Human immunodeficiency virus-negative plasmablastic lymphoma: a comprehensive analysis of 114 cases. Oncol Rep 2015; 33: 1615-20.
8.
Delecluse HJ, Anagnostopoulos I, Dallenbach F, et al. Plasmablastic lymphomas of the oral cavity: a new entity associated with the human immunodeficiency virus infection. Blood 1997; 89: 1413-20.
9.
Castillo JJ, Winer ES, Stachurski D, et al. Clinical and pathological differences between human immunodeficiency virus-positive and human immunodeficiency virus-negative patients with plasmablastic lymphoma. Leuk Lymphoma 2010; 51: 2047-53.
10.
Zelenetz AD, Gordon LI, Abramson JS, et al. NCCN guidelines insights: B-cell lymphomas, version 3.2019. J Natl Compr Canc Netw 2019; 17: 650-61.
11.
Koizumi Y, Uehira T, Ota Y, et al. Clinical and pathological aspects of human immunodeficiency virus-associ-ated plasmablastic lymphoma: analysis of 24 cases. Int J Hematol 2016; 104: 669-81.
12.
Wang D, Zheng Y, Zeng D, et al. Clinicopathologic characteristics of HIV/AIDS-related plasmablastic lymphoma. Int J STD AIDS 2017; 28: 380-8.
13.
Nasta SD, Carrum GM, Shahab I, Hanania NA, Udden MM. Regression of a plasmablastic lymphoma in a patient with HIV on highly active antiretroviral therapy. Leuk Lymphoma 2002; 43: 423-6.
14.
Armstrong R, Bradrick J, Liu YC. Spontaneous regression of an HIV-associated plasmablastic lymphoma in the oral cavity: a case report. J Oral Maxillofac Surg 2007; 65: 1361-4.
15.
Tchernonog E, Faurie P, Coppo P, et al. Clinical characteristics and prognostic factors of plasmablastic lymphoma patients: analysis of 135 patients from the LYSA group. Ann Oncol 2017; 28: 843-8.
16.
Liu JJ, Zhang L, Ayala E, et al. Human immunodeficiency virus (HIV)-negative plasmablastic lymphoma: a single institutional experience and literature review. Leuk Res 2011; 35: 1571-7.
17.
Cesarman E. Gammaherpesviruses and lymphoproliferative disorders. Annu Rev Pathol 2014; 9: 349-72.
18.
Sukswai N, Lyapichev K, Khoury JD, Medeiros LJ. Diffuse large B-cell lymphoma variants: an update. Pathology 2020; 52: 53-67.
19.
Pan Z, Hu S, Li M, et al. ALK-positive large B-cell lymphoma: a clinicopathologic study of 26 cases with review of additional 108 cases in the literature. Am J Surg Pathol 2017; 41: 25-38.
20.
Qunaj L, Castillo JJ, Olszewski AJ. Survival of patients with CD20-negative variants of large B-cell lymphoma: an analysis of the National Cancer Data Base. Leuk Lymphoma 2018; 59: 1375-83.
21.
Arora N, Eule C, Gupta A, Li HC, Sadeghi N. Clinicopathologic features, management, and outcomes of plasmablastic lymphoma: a 10-year experience. Am J Hematol 2019; 94: E127-9.
22.
Loghavi S, Alayed K, Aladily TN, et al. Stage, age, and EBV status impact outcomes of plasmablastic lymphoma patients: a clinicopathologic analysis of 61 patients. J Hematol Oncol 2015; 8: 65.
23.
Barta SK, Lee JY, Kaplan LD, Noy A, Sparano JA. Pooled analysis of AIDS malignancy consortium trials evaluating rituximab plus CHOP or infusional EPOCH chemotherapy in HIV-associated non-Hodgkin lymphoma. Cancer 2012; 118: 3977-83.
24.
Petrich AM, Gandhi M, Jovanovic B, et al. Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: a multicenter retrospective analysis. Blood 2014; 124: 2354-61.
25.
Castillo JJ, Reagan JL, Sikov WM, Winer ES. Bortezomib in combination with infusional dose-adjusted EPOCH for the treatment of plasmablastic lymphoma. Br J Haematol 2015; 169: 352-5.
26.
Dittus C, Grover N, Ellsworth S, Tan X, Park SI. Bortezomib in combination with dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) induces long-term survival in patients with plasmablastic lymphoma: a retrospective analysis. Leuk Lymphoma 2018; 59: 2121-7.
27.
Castillo JJ, Guerrero-Garcia T, Baldini F, et al. Bortezomib plus EPOCH is effective as frontline treatment in patients with plasmablastic lymphoma. Br J Haematol 2019; 184: 679-82.
28.
Jayachandran PK, Rajan AK, Karunakaran P, et al. Plasmablastic lymphoma – single centre experience with infusional EPOCH chemotherapy. Leuk Res 2020; 95: 106391.
29.
Schmit JM, DeLaune J, Norkin M, Grosbach A. A case of plasmablastic lymphoma achieving complete response and durable remission after lenalidomide-based therapy. Oncol Res Treat 2017; 40: 46-8.
30.
Yanamandra U, Sahu KK, Jain N, Prakash G, Saikia U, Malhotra P. Plasmablastic lymphoma: successful management with CHOP and lenalidomide in resource constraint settings. Ann Hematol 2016; 95: 1715-7.
31.
Krishnan A, Palmer JM, Zaia JA, Tsai NC, Alvarnas J, Forman SJ. HIV status does not affect the outcome of autologous stem cell transplantation (ASCT) for non-Hodgkin lymphoma (NHL). Biol Blood Marrow Transplant 2010; 16: 1302-8.
32.
Al-Malki MM, Castillo JJ, Sloan JM, Re A. Hematopoietic cell transplantation for plasmablastic lymphoma: a review. Biol Blood Marrow Transplant 2014; 20: 1877-84.
33.
Dunleavy K, Wilson WH. How I treat HIV-associated lymphoma. Blood 2012; 119: 3245-55.
34.
Cattaneo C, Finel H, McQuaker G, Vandenberghe E, Rossi G, Dreger P. Autologous hematopoietic stem cell transplantation for plasmablastic lymphoma: the European Society for Blood and Marrow Transplantation experience. Biol Blood Marrow Transplant 2015; 21: 1146-7.
35.
Balsalobre P, Díez-Martín JL, Re A, et al. Autologous stem-cell transplantation in patients with HIV-related lymphoma. J Clin Oncol 2009; 27: 2192-8.
36.
Nishi K, Mitani S, Hatanaka K, Imada K. Successful cord blood transplantation for an HIV-negative patient with refractory plasmablastic lymphoma. Ann Hematol 2017; 96: 1057-8.
37.
Montes-Moreno S, Martinez-Magunacelaya N, Zecchini-Barrese T, et al. Plasmablastic lymphoma phenotype is determined by genetic alterations in MYC and PRDM1. Mod Pathol 2017; 30: 85-94.
38.
Witte HM, Hertel N, Merz H, et al. Clinicopathological characteristics and MYC status determine treatment outcome in plasmablastic lymphoma: a multi-center study of 76 consecutive patients. Blood Cancer J 2020; 10: 63.
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