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Blood:原发性渗出性淋巴瘤!

2018-08-30 MedSci MedSci原创

原发性渗出性淋巴瘤(PEL)是一种罕见的B细胞恶性肿瘤,主要发生于免疫功能不全的患者,如HIV感染者和进行器官移植的患者。PEL的主要特征是恶性渗出,表现为浆膜腔积液,一般无肿瘤包块。其发病与8型人疱疹病毒/卡波西肉瘤相关疱疹病毒潜伏感染相关,肿瘤细胞的正常对应细胞为向浆细胞分化的B细胞。免疫缺陷和缺乏CD20表达导致抗CD20单克隆抗体缺乏预期的疗效;PEL的临床预后极其不良,1年总体存活率仅3

原发性渗出性淋巴瘤(PEL)是一种罕见的B细胞恶性肿瘤,主要发生于免疫功能不全的患者,如HIV感染者和进行器官移植的患者。PEL的主要特征是恶性渗出,表现为浆膜腔积液,一般无肿瘤包块。

其发病与8型人疱疹病毒/卡波西肉瘤相关疱疹病毒潜伏感染相关,肿瘤细胞的正常对应细胞为向浆细胞分化的B细胞。免疫缺陷和缺乏CD20表达导致抗CD20单克隆抗体缺乏预期的疗效;PEL的临床预后极其不良,1年总体存活率仅30%。

尽管抗逆转录病毒疗法的进展改善了HIV感染患者的预后,但对于PEL患者,预后仍未得到明显改善。此外,肿瘤细胞一般高表达PDL1,一种重要的免疫检查点分子,可导致肿瘤细胞逃脱宿主免疫防御,这可能是PEL治疗效果差的潜在机制。针对PEL的激活的信号通路的分子靶向疗法,如NF-κB、JAK/STAT和PI3K/AKT,已开始应用于治疗PEL。

将免疫缺陷恢复、克服免疫逃逸和开发更为有效的药物三者结合起来,对提高PEL患者的预后至关重要。

原始出处:

Kazuyuki Shimada, Fumihiko Hayakawa, and Hitoshi Kiyoi. Biology and management of primary effusion lymphoma. Blood  2018  :blood-2018-03-791426;  doi: https://doi.org/10.1182/blood-2018-03-791426

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    2018-08-30 phoebeyan520

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