Durable remission is achievable with localized treatment and reduction of immunosuppression in limited stage EBV-related plasmablastic lymphoma

Phipps, Colin; Yeoh, Kheng Wei; Lee, Y. S.; Nagarajan, Chandramouli; Gopalakrishnan, Sathish; Ho, Liam Pock; Hwang, William Ying Khee; Goh, Yeow Tee; Grigoropoulos, Nicholas F.

doi:10.1007/s00277-017-3109-4

Cited by 8 publications

(9 citation statements)

References 4 publications

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“…The range of treatments delivered to PbL patients has been extensive, from local control with radiotherapy in patients with localized disease to a variety of chemotherapy combinations 29. Chemotherapy treatments have included CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like regimens, Hyper-CVAD-MA (hyper-fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, and high-dose methotrexate and cytarabibe), CODOX-M/IVAC (cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, and high-dose cytarabine), COMB (cyclophosphamide, Oncovin, methyl-CCNU, and bleomycin), and infusional EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) 17,30,31.…”

Section: Treatmentmentioning

confidence: 99%

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Plasmablastic lymphoma: current perspectives

López¹,

Abrisqueta²

2018

BLCTT

111

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Plasmablastic lymphoma (PbL) is a rare and aggressive B-cell malignancy with large neoplastic cells, most of them resembling plasmablasts that have a CD20-negative phenotype. Although initially described as being associated with HIV, over the years it has also been identified in patients with solid organ transplant and immunocompetent patients. Little is known about molecular basis that drives PbL, and still its diagnosis remains challenging given its rarity. However, proper recognition of its clinical characteristics, localization, and morphological features can establish a correct diagnosis of PbL within the spectrum of CD20-negative large B-cell lymphomas (LBCLs). PbL is characterized by CD20 and PAX5 negativity together with the expression of CD38, CD138, MUM1/IRF4, Blimp1, and XBP1 plasmacytic differentiation markers. It is usually associated with Epstein–Barr virus infections, and MYC gene rearrangements. PbL should be carefully differentiated from other CD20-negative B-cell neoplasms, ie, primary effusion lymphoma, anaplastic lymphoma kinase-positive (ALK) large B-cell lymphoma, and LBCL in human herpesvirus 8-associated multicentric Castleman disease. Despite our improved understanding of this disease, its prognosis remains dismal with short overall survival. There is no standard of care for this entity. Several chemotherapy combinations have been used with hardly any differences on its outcome. Thus, new approaches with the addition of novel molecules are needed to overcome its poor prognosis. Our current understanding and knowledge of PbL relies primarily on case reports and small case series. In this review, we revise through an extensive literature search, the clinical and biological characteristics of this entity, and the potential therapeutic options.

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Section: Treatmentmentioning

confidence: 99%

“…Patients with localized disease have a better prognosis, and in some circumstances are not subsidiary of aggressive treatments. In these cases, disease control has been achieved with radiotherapy or combining doxorubicin-based chemotherapy with radiation therapy 29,34. However, the experience with radiotherapy alone is limited.…”

Section: Treatmentmentioning

confidence: 99%

Plasmablastic lymphoma: current perspectives

López¹,

Abrisqueta²

2018

BLCTT

111

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“…In patients with localized disease, radiotherapy alone or combined with chemotherapy may achieve good disease control in some cases. The use of radiation therapy in advanced PBL is usually not considered in the first-line setting but could be entertained in relapsed/refractory patients [ 21 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Bortezomib, Lenalidomide and Dexamethasone Combination Induced Complete Remission in Relapsed/Refractory Plasmablastic Lymphoma: Case Report of a Potential Novel Treatment Approach

Sabry

Kodad

2022

Current Oncology

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Plasmablastic lymphoma is a rare subtype of large B-cell lymphoma characterised by an aggressive clinical course with frequent relapses and refractoriness to chemotherapy. It is usually associated with HIV, however, it can also be seen in immunocompetent patients. It has distinct pathological characteristics, such as plasmablastic morphology and lack of CD20 expression. These characteristics pose a clinical and pathological challenge. There is no standard of care established in this entity. In this case report, we described a novel bortezomib-based plasma cell targeted regimen in a HIV-negative patient refractory to chemotherapy.

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“…11 The range of treatments delivered to PbL patients has been extensive, from local control with radiotherapy in patients with localized disease to a variety of chemotherapy combinations. 12 Patients with localized disease have a better prognosis. In these cases, disease control has been achieved with radiotherapy or combining doxorubicin-based chemotherapy with radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In these cases, disease control has been achieved with radiotherapy or combining doxorubicin-based chemotherapy with radiation therapy. 12 There are no standards of care defining the optimal therapeutic approach. Treatment regimens have been largely varied without established consensus, although literature suggest overall response of PbL to chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Plasmablastic lymphoma of nose and para-nasal sinuses in an immunocompetent patient

Chakravati

Mojahid

Nair

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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<p class="abstract">Plasmablastic lymphoma (PbL) is a rare and aggressive neoplasm with heterogeneous clinical, histological and genetic features. It has been reported in both immuno-compromised and immuno-competent patients and commonly presents in the extra-nodal regions, but it is more heterogeneous in immuno-competent patients. Its clinical course is aggressive with early dissemination and poor response to therapy. A 61 year old male presented with left sided nasal bleeding and nasal obstruction for last 6 months, snoring and disturbed sleep for last 2 months. On examination, there was fullness over left side of nose and obliteration of left naso-facial groove. A mass lesion was seen in the left nasal cavity on endoscopy. There was bulge in the soft palate and the mass extended into the oropharynx. CECT showed a locally aggressive sino-nasal mass. Histopathology and immuno-histo-chemistry (IHC) of the biopsy were suggestive of plasmablastic lymphoma. A debulking surgery was done to relieve his obstructive symptoms. The patient received 3 cycles of EPOCH chemotherapy and radiotherapy to local site. At 9 months of follow up he presented with recurrence of the mass. Plasmablastic lymphoma presents in patients other than those with HIV. Awareness about its unique characteristics is crucial for establishing a correct diagnosis. Currently available treatments are ineffective in achieving long term remission and prognosis remains unfavourable with high incidence of recurrence</p>

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Durable remission is achievable with localized treatment and reduction of immunosuppression in limited stage EBV-related plasmablastic lymphoma

Cited by 8 publications

References 4 publications

Plasmablastic lymphoma: current perspectives

Plasmablastic lymphoma: current perspectives

Bortezomib, Lenalidomide and Dexamethasone Combination Induced Complete Remission in Relapsed/Refractory Plasmablastic Lymphoma: Case Report of a Potential Novel Treatment Approach

Plasmablastic lymphoma of nose and para-nasal sinuses in an immunocompetent patient

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