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Plasmablastic Lymphoma: A Review of Current Knowledge and Future Directions.

Elyamany G, Al Mussaed E, Alzahrani AM - Adv Hematol (2015)

Bottom Line: There is no standard chemotherapy protocol for treatment of PBL.Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens have been the backbone while more intensive regimens such as cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, high-dose cytarabine (CODOX-M/IVAC), or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH) are possible options.Recently, a few studies have reported the potential value of the proteasome inhibitor bortezomib and thalidomide in PBL patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Blood Bank, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia ; Department of Hematology, Theodor Bilharz Research Institute, Egypt.

ABSTRACT
Plasmablastic lymphoma (PBL) is an aggressive subtype of non-Hodgkin's lymphoma (NHL), which frequently arises in the oral cavity of human immunodeficiency virus (HIV) infected patients. PBL shows diffuse proliferation of large neoplastic cells resembling B-immunoblasts/plasmablasts, or with plasmacytic features and an immunophenotype of plasma cells. PBL remains a diagnostic challenge due to its peculiar morphology and an immunohistochemical profile similar to plasma cell myeloma (PCM). PBL is also a therapeutic challenge with a clinical course characterized by a high rate of relapse and death. There is no standard chemotherapy protocol for treatment of PBL. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens have been the backbone while more intensive regimens such as cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, high-dose cytarabine (CODOX-M/IVAC), or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH) are possible options. Recently, a few studies have reported the potential value of the proteasome inhibitor bortezomib and thalidomide in PBL patients. The introduction of genes encoding artificial receptors called chimeric antigen receptors (CARs) and CAR-modified T cells targeted to the B cell-specific CD19 antigen have demonstrated promising results in multiple early clinical trials. The aim of this paper is to review the recent advances in epidemiology; pathophysiology; clinical, pathologic, and molecular characteristics; therapy; and outcome in patients with PBL.

No MeSH data available.


Related in: MedlinePlus

Histopathologic features of PBL: (a) H&E stain shows sheets of large atypical lymphoid cells with plasmacytic differentiation with abundant cytoplasm, paranuclear hof, and large nuclei; (b) it displays large cells with an immunoblastic appearance, with central oval nuclei with prominent nucleoli and moderately abundant cytoplasm.
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fig1: Histopathologic features of PBL: (a) H&E stain shows sheets of large atypical lymphoid cells with plasmacytic differentiation with abundant cytoplasm, paranuclear hof, and large nuclei; (b) it displays large cells with an immunoblastic appearance, with central oval nuclei with prominent nucleoli and moderately abundant cytoplasm.

Mentions: Overall, PBL is characterized by cellular proliferation of large atypical cells with immunoblastic, plasmablastic, or plasmacytic features, including eccentric nuclei with a vesicular chromatin, either prominent central nucleolus or peripheral nucleoli, abundant eosinophilic cytoplasm, and a perinuclear hof, in a diffuse sheet-like and cohesive growth pattern (Figure 1). Apoptotic bodies and mitotic figures are frequent, and tingible-body macrophages are easily detectable leading to a starry-sky appearance. Smaller neoplastic cells with obvious plasmacytic differentiation may also be present. Areas of necrosis are occasionally identified [1, 3].


Plasmablastic Lymphoma: A Review of Current Knowledge and Future Directions.

Elyamany G, Al Mussaed E, Alzahrani AM - Adv Hematol (2015)

Histopathologic features of PBL: (a) H&E stain shows sheets of large atypical lymphoid cells with plasmacytic differentiation with abundant cytoplasm, paranuclear hof, and large nuclei; (b) it displays large cells with an immunoblastic appearance, with central oval nuclei with prominent nucleoli and moderately abundant cytoplasm.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555447&req=5

fig1: Histopathologic features of PBL: (a) H&E stain shows sheets of large atypical lymphoid cells with plasmacytic differentiation with abundant cytoplasm, paranuclear hof, and large nuclei; (b) it displays large cells with an immunoblastic appearance, with central oval nuclei with prominent nucleoli and moderately abundant cytoplasm.
Mentions: Overall, PBL is characterized by cellular proliferation of large atypical cells with immunoblastic, plasmablastic, or plasmacytic features, including eccentric nuclei with a vesicular chromatin, either prominent central nucleolus or peripheral nucleoli, abundant eosinophilic cytoplasm, and a perinuclear hof, in a diffuse sheet-like and cohesive growth pattern (Figure 1). Apoptotic bodies and mitotic figures are frequent, and tingible-body macrophages are easily detectable leading to a starry-sky appearance. Smaller neoplastic cells with obvious plasmacytic differentiation may also be present. Areas of necrosis are occasionally identified [1, 3].

Bottom Line: There is no standard chemotherapy protocol for treatment of PBL.Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens have been the backbone while more intensive regimens such as cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, high-dose cytarabine (CODOX-M/IVAC), or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH) are possible options.Recently, a few studies have reported the potential value of the proteasome inhibitor bortezomib and thalidomide in PBL patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Blood Bank, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia ; Department of Hematology, Theodor Bilharz Research Institute, Egypt.

ABSTRACT
Plasmablastic lymphoma (PBL) is an aggressive subtype of non-Hodgkin's lymphoma (NHL), which frequently arises in the oral cavity of human immunodeficiency virus (HIV) infected patients. PBL shows diffuse proliferation of large neoplastic cells resembling B-immunoblasts/plasmablasts, or with plasmacytic features and an immunophenotype of plasma cells. PBL remains a diagnostic challenge due to its peculiar morphology and an immunohistochemical profile similar to plasma cell myeloma (PCM). PBL is also a therapeutic challenge with a clinical course characterized by a high rate of relapse and death. There is no standard chemotherapy protocol for treatment of PBL. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens have been the backbone while more intensive regimens such as cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, high-dose cytarabine (CODOX-M/IVAC), or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH) are possible options. Recently, a few studies have reported the potential value of the proteasome inhibitor bortezomib and thalidomide in PBL patients. The introduction of genes encoding artificial receptors called chimeric antigen receptors (CARs) and CAR-modified T cells targeted to the B cell-specific CD19 antigen have demonstrated promising results in multiple early clinical trials. The aim of this paper is to review the recent advances in epidemiology; pathophysiology; clinical, pathologic, and molecular characteristics; therapy; and outcome in patients with PBL.

No MeSH data available.


Related in: MedlinePlus