Improving Outcomes for Patients with Diffuse Large B-Cell Lymphoma
Improving Outcomes for Patients with Diffuse Large B-Cell Lymphoma
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DOI：
10.3322/caac.20087
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发表时间：
2010-11-01
影响因子：
254.7
通讯作者：
Vose, Julie M.
中科院分区：
文献类型：
--
作者：
Flowers, Christopher R.;Sinha, Rajni;Vose, Julie M.
弥漫性大B细胞淋巴瘤（DLBCL）是西方世界最常见的非霍奇金淋巴瘤。直到20世纪90年代中期，DLBCL的发病率在两种性别、不同种族和除极年轻人群外的所有年龄组中均有所增加，大多数病例的病因仍不清楚。DLBCL与侵袭性自然史相关，但它可以用联合化疗方案治愈，如环磷酰胺，多柔比星，长春新碱和泼尼松（CHOP），这是几十年来的主要治疗方法。在了解DLBCL的生物学异质性以及通过化疗和免疫治疗的新组合改善DLBCL患者的生存方面取得了显着进展。基因表达谱（GEP）已经发现了具有不同临床行为和症状的DLBCL亚型，并且将单克隆抗体利妥昔单抗添加到CHOP中显著改善了结果。DLBCL管理的未来方法将使用通过GEP鉴定的分子特征来提供预后信息，并分离正在为复发或患有高风险疾病的DLBCL患者评估的治疗靶点。CA Cancer J Clin 2010;60：393-408. 2010年美国癌症协会（American Cancer Society，Inc.）
Diffuse large B-cell lymphoma (DLBCL) is the most commonly occurring form of non-Hodgkin lymphoma in the western world. Until the mid 1990s the incidence of DLBCL increased in both sexes, across racial categories, and across all age groups except the very young, the etiology of most cases remains unknown. DLBCL is associated with an aggressive natural history, but it can be cured with combination chemotherapy regimens like cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), which has been the mainstay of therapy for several decades. Remarkable progress has been made in understanding the biological heterogeneity of DLBCL and in improving survival for DLBCL patients with novel combinations of chemotherapy and immunotherapy. Gene expression profiling (GEP) has uncovered DLBCL subtypes that have distinct clinical behaviors and prognoses, and the addition of the monoclonal antibody, rituximab, to CHOP has markedly improved outcomes. Future approaches to DLBCL management will use molecular signatures identified through GEP to provide prognostic information and to isolate therapeutic targets that are being evaluated for DLBCL patients who relapse or those with high risk disease. CA Cancer J Clin 2010;60:393-408. (C)2010 American Cancer Society, Inc.