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Hepatitis C and B-cell lymphoma.   总被引:3,自引:0,他引:3  
The association between the hepatitis C virus and B-cell non-Hodgkin's lymphomas is controversial. We review the epidemiological evidence behind the association, and look at the reasons behind the variation in study findings. There is increasing evidence of the pathogenesis of hepatitis C-associated lymphoma. Treatment of the hepatitis C virus with antiviral therapy may lead to the regression of some low-grade lymphomas. The management of other hepatitis C-associated lymphomas is similar to that of conventional lymphoma, although viral reactivation and subsequent immune reconstitution hepatitis can complicate chemotherapy.  相似文献   

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B 细胞淋巴瘤是恶性B 细胞单克隆扩增的一组异质性肿瘤,约占非霍奇金淋巴瘤(non-Hodgkin lymphoma ,NHL )的85% 。以利妥昔单抗为代表的免疫治疗联合化疗在B 细胞淋巴瘤治疗中获得了巨大成功,患者生存期得到显著改善,但仍有部分复发或病情进展。随着研究和治疗水平的提高,新的靶向药物不断研发和临床应用,自体造血干细胞移植、细胞免疫治疗、放射免疫治疗在血液系统肿瘤中获得较大的进展,给B 细胞淋巴瘤的治疗提供了更多的选择,本文就其最新治疗研究进行综述,并探讨未来治疗的发展方向。  相似文献   

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A human diffuse large cell lymphoma line (WSU-DLCL) expressing multidrug resistance (MDR) was established from a patient with primary chemotherapy-resistant disease. This cell line has the same phenotypic features as malignant cells from the patient. The established cell line has features of a mature B-cell neoplasm with no evidence for commitment to other lineages. WSU-DLCL grows in suspension forming relatively large clumps of cells with a doubling time of 20 hours. By light microscopic examination, the cells are very large with primitive lymphoid features, have a large amount of cytoplasm containing numerous vacuoles and an irregular outline. Immunophenotypic characterization by monoclonal antibodies and flow cytometric analysis showed a monoclonal IgM kappa B-cell phenotype with high expression of the multidrug-resistant P-glycoprotein compared with either normal peripheral blood lymphocytes or cells of the REH cell line. The cells were negative for T-cell and myeloid/monocyte antigens as well as Epstein-Barr virus nuclear antigen (EBNA). In addition, the cell line expressed high levels of MDR RNA. DNA histogram generated by flow cytometry indicated a DNA index of 1.83. Cytogenetic analysis confirmed hypertriploidy and showed complex chromosomal abnormalities including 14q+. This cell line should be a valuable tool to study the role of the MDR gene in the primary resistance of lymphomas to chemotherapy and to facilitate therapeutic investigations.  相似文献   

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目的:分析介于弥漫大B 细胞淋巴瘤和伯基特淋巴瘤之间的未分类的B 细胞淋巴瘤(B-cell lymphoma ,unclassifiable,with features intermediate between DLBCL and Burkitt lymphoma,DLBCL/BL)的临床特点、治疗与预后,增加对该病的认识。方法:收集郑州大学第一附属医院2013年1 月至2014年12月收治的13例DLBCL/BL患者临床病理资料,采用Kaplan-Meier 法进行生存分析,采用Logrank 检验对临床分期、年龄、LDH 水平、IPI 评分、初治化疗方案等进行单因素分析。结果:13例患者中12例存在结外侵犯,13例患者的中位OS为10个月,中位PFS 为6 个月。单因素分析显示IPI 评分、LDH 水平与预后有统计学相关性,行CHOP、CHOP 样与高强度化疗方案患者之间生存差异具有统计学意义(P = 0.054)。 结论:DLBCL/BL恶性程度高,生存期短,结外侵犯多见,对CHOP 及CHOP 样方案治疗反应差,高强度化疗可能改善预后,IPI 评分≥ 3 分及 LDH 升高是其不良预后因素。  相似文献   

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Molecular pathogenesis of diffuse large B-cell lymphoma.   总被引:5,自引:0,他引:5  
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous clinicopathologic entity accounting for 30% of non-Hodgkin's lymphomas. The pathogenesis of DLBCL is complex and heterogeneous. Recent studies using analysis of global gene expression with DNA microarrays and the classical molecular approaches demonstrate presence of several DLBCL subtypes characterized by different cells of origin, cytogenetic and molecular aberrations, and distinct pathogenesis. This review summarizes the progress in understanding of DLBCL biology and presents a state-of-the-art overview of DLBCL molecular pathogenesis.  相似文献   

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近年来放射免疫治疗(RIT)有了很大的发展,两个放射免疫结合物,^90Y—ibritumomab tiuxetan和^131 I-tositumomab已获得美国FDA批准用于治疗B细胞性非霍奇金淋巴瘤(NHL),尚有一些放射免疫结合物正在进行临床试验。放射免疫结合物治疗惰性NHL,有效率约80%,完全缓解率25%~30%;主要不良反应为可逆转的骨髓抑制。现综述RIT在B细胞NHL的作用机制及研究进展。  相似文献   

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CNS involvement in primary mediastinal large B-cell lymphoma.   总被引:4,自引:0,他引:4  
PURPOSE: The risk of CNS involvement by non-Hodgkin's Lymphoma (NHL) has been associated with bone marrow and/or testicular involvement; however, it was recently reported that the number of extranodal sites is a more reliable predictor of CNS disease. Because primary mediastinal thymic large B-cell lymphoma (PMLCL) has a high propensity for involving extranodal sites, we investigated the frequency and pattern of CNS involvement in PMLCL. PATIENTS AND METHODS: The medical records of 219 patients with aggressive NHL, consecutively entered onto protocols at the National Cancer Institute between 1987 and 1998, were retrospectively reviewed. RESULTS: Twenty-three patients (11%) had clinical and pathologic features of PMLCL. These patients were young (median age, 29 years), female (61%), and presented with massive mediastinal adenopathy (70%). Extranodal disease occurred at presentation in 70% and at relapse in 93% of patients and involved contiguous intrathoracic structures and/or distant sites, including the lungs, kidneys, liver, adrenals, ovaries, pancreas, and bone. Six patients (26%) developed CNS involvement, two (9%) at presentation and four (27%) at relapse. All had extranodal disease, but only one had bone marrow involvement. Parenchymal and leptomeningeal CNS disease occurred in four and three patients, respectively. CONCLUSION: CNS involvement in PMLCL is associated with extranodal involvement other than bone marrow and may reflect the unique biology of this disease. The propensity to involve the CNS parenchyma raises the concern that intrathecal prophylaxis may not be effective and suggests that CNS imaging should be considered in patients with extranodal disease.  相似文献   

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Translocation (14;18)(q32;q21), which is detected in 20-30% of diffuse large B-cell lymphomas (DLBCL), is regarded as a major mechanism for BCL2 protein overexpression. Nevertheless, BCL2 overexpression is not always caused by t(14;18), because it is often detected in lymphomas without BCL2 rearrangement. Recent studies have shown that increased expression of BCL2 may also result from BCL2 gene amplification in DLBCL. Similarly, it has been speculated that the mutations of the open reading frame might cause increased expression of BCL2 by affecting the interactions of BCL2 with other proteins. The results obtained from studies on the association of BCL2 protein overexpression with survival of DLBCL are controversial, although a correlation with decreased overall survival seems to exist. However, BCL2 rearrangement does not seem to have any major association with poor prognosis, but it is difficult to assess its true impact on prognosis due to differences in treatment and follow-up, and methodologies applied to study the BCL2 rearrangement. This review summarizes the BCL2 expression studies in DLBCL and discusses the prognostic relevance of BCL2 overexpression and its mechanisms.  相似文献   

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Novel panning and screening methodology was devised to isolate high affinity human recombinant scFv antibody fragments with functionally associated properties in B lymphoma cells. The approach was used to generate a panel of apoptosis‐inducing antibodies specific for antigens differentially expressed in B lymphoma vs. T leukaemia cells. The selections resulted in an antibody pool with near perfect selectivity (>99%) for the B lymphoma target cells. Randomly picked clones (72) revealed 7 unique antibody genotypes. Six of these rapidly induced apoptosis in target cells. Following the conversion to full IgGs, the antibodies were shown to be specific for HLA‐DR/DP, the B‐cell receptor μ chain and for CD54/ICAM‐1. The latter receptor was not previously associated with apoptotic properties in B‐cell lymphomas. Anti‐ICAM‐1 IgG induced apoptosis in a broad range of B lymphoma cell lines and were shown by immunohistochemistry to bind strongly to B lymphoma tissue obtained from 5 different B lymphoma patients. The recombinant IgG antibodies had affinities in the subnanomolar (0.3 nM) to nanomolar (3 nM) range. The described technology is generally applicable for the rapid isolation of high affinity human antibodies with specificity for differentially expressed cell surface receptors with intrinsic negative or positive signalling properties from naïve phage libraries. © 2006 Wiley‐Liss, Inc.  相似文献   

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State-of-the-art therapeutics: diffuse large B-cell lymphoma.   总被引:3,自引:0,他引:3  
This article is a review of the improvement in the treatment of patients with diffuse large B-cell lymphoma made during the last 10 years. Patients with diffuse large B-cell lymphoma now have a better outcome with longer survival because of two major developments: (1) increasing the dose of active drugs with shortening the time between cycles, resulting in dose-dense and/or dose-intense regimens; and (2) combining rituximab with chemotherapy. Both strategies were associated with higher response rates, lower relapse rates, longer event-free survival, longer time to progression, and longer overall survival, particularly in patients without adverse prognostic parameters. A combination of dose-dense, dose-intense regimens plus rituximab is currently being tested for poor-risk patients with diffuse large B-cell lymphoma. However, much work has to be done for patients with high-risk lymphoma. It may come with a better definition of genetic abnormalities specifically associated with refractoriness to chemotherapy.  相似文献   

13.
J Hirota  T Osaki  K Yoneda  T Yamamoto  E Ueta  M Hiroi  H Hara 《Cancer》1992,70(12):2958-2962
This article presents a case of lethal midline granuloma on the palate of a 44-year-old woman, which had been identified histologically as B-cell lymphoma with leukemic transformation in the terminal stages. At the first visit, physical and laboratory examinations showed no remarkable findings except for a necrotizing ulcer of the palate, and the biopsy specimens only showed massive inflammatory cell infiltration and necrosis of the granulation tissue. There was a short-term resolution after treatment with cyclophosphamide and prednisolone, but the disease reactivated and the necrotic ulcerative lesion progressively advanced into the nasal cavity. Specimens from the third biopsy exhibited histologic features that were consistent with malignant lymphoma of the diffuse, mixed B-cell type. Chemotherapy with the regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone was adopted but was interrupted after a short time because of bone marrow suppression. Subsequently, large numbers of enlarged abnormal lymphocytes with a few vacuoles in the cytoplasm appeared in the circulating blood, indicating leukemic transformation of the midline lymphoma. The patient died on the seventh day after the initiation of chemotherapy. In the presentation of this case, the authors mention clinically important matters regarding midline lethal lymphoma and briefly discuss the pathophysiology and pathogenesis.  相似文献   

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目的:研究干扰素诱导蛋白-10(interferon induced protein 10,IP-10)对人弥漫大B细胞淋巴瘤SU-DHL-4细胞株增殖、侵袭性及耐药性的影响。方法:SU-DHL-4细胞被分为3个实验组和1个对照组,3个实验组根据IP-10的刺激浓度,分别为10、100、1 000 ng/ml组,对照组不予刺激。24、48和72 h 后通过噻唑蓝(MTT)法分别检测4组细胞的增殖情况;IP-10刺激24 h后通过Transwell法检测SU-DHL-4细胞的迁移和侵袭能力;IP-10刺激48 h后通过流式细胞染色测定P-糖蛋白(P-glycoprotein,P-gp)和多药耐药相关蛋白1(multidrug resistance-associated protein 1,MRP1)的表达情况。结果:与对照组相比,24 h和48 h时,10、100和1 000 ng/ml浓度的IP-10均能够促进SU-DHL-4 细胞的增殖(P<0.05);在24 h时,与对照组相比,3组细胞迁移和侵袭能力均显著增强(P<0.05);在48 h时,与对照组相比,3组细胞P-gp和MRP1表达均无显著变化(P>0.05)。结论:IP-10 既能促进SU-DHL-4细胞的增殖,又能增强其迁移和侵袭能力,但对SU-DHL-4细胞耐药蛋白表达没有影响。  相似文献   

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P Isaacson  D H Wright 《Cancer》1983,52(8):1410-1416
As illustrated in the two cases described in this paper close morphologic and immunohistochemical similarities exist between Mediterranean lymphoma (MTL) and primary gastrointestinal lymphoma of follicle center cell (FCC) origin as it occurs in Western countries. Similarities between the two conditions include a dense noninvasive monotypic lamina propria plasma cell infiltrate, present in all cases of MTL and in some cases of Western gastrointestinal FCC lymphoma, and an invasive infiltrate of FCCs morphologically distinct from the plasma cells. A distinctive lesion produced by individual gland invasion characterizes both types of lymphoma. A clonal relationship between the lamina propria plasma cells and the invasive FCCs, long suspected but never proved in MTL, can be demonstrated in Western cases. Many of the histologic and clinical features common to these lymphomas can be explained in the context of the normal maturation sequences of gut associated lymphoid tissue. It is suggested that MTL and Western cases of primary FCC gastrointestinal lymphoma share a common histogenesis from mucosa associated lymphoid tissue.  相似文献   

17.
Chromosomal translocations involving the immunoglobulin loci are a hallmark of many types of B-cell lymphoma. Other factors, however, also have important roles in the pathogenesis of B-cell malignancies. Most B-cell lymphomas depend on the expression of a B-cell receptor (BCR) for survival, and in several B-cell malignancies antigen activation of lymphoma cells through BCR signalling seems to be an important factor for lymphoma pathogenesis. Recent insights into the lymphomagenic role of factors supplied by the microenvironment also offer new therapeutic strategies.  相似文献   

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Molecular mapping of the cell surface has probably proceeded further with the human lymphocyte than with any other mammalian cell, and the B lymphocyte yields a wide range of subtly varying neoplasms. These two bodies of knowledge are now readily correlated, given the widespread adoption of a modern lineage-based classification of lymphoma (Revised European-American). Studies of the markers of B-cell lymphoma have immediate practical importance in diagnosis, defining clonality, and detecting minimal residual disease. They also help to keep us abreast of lymphocyte physiology, and present new opportunities for treating these neoplasms.  相似文献   

20.
Molecular features of B-cell lymphoma   总被引:3,自引:0,他引:3  
Malignant transformation of B cells can occur at various steps of lymphocyte development, starting from early B-cell progenitors up to mature B cells, which reflects the heterogeneity of B-cell malignancies with regard to their biologic and clinical behavior. The genetic characterization of B-cell neoplasms during the past two decades has elucidated the mechanisms underlying B-cell lymphomagenesis and led to a more precise definition of lymphoma subgroups. This progress is reflected in the upcoming World Health Organization classification for hematologic neoplasms, which stresses the diagnostic importance of recurrent genetic alterations in leukemias and lymphomas. In the recent past, several genes deregulated by such recurrent chromosomal aberrations have been identified. In addition, the recent introduction of microarray technology has now allowed a more global assessment of gene dysregulation in B-cell oncogenesis and provided a new means for more exactly defining the molecular hallmarks of distinct lymphoma subtypes. This review will focus on recently described molecular features of B-cell lymphomas discovered by the application of new molecular cytogenetic techniques, advanced breakpoint cloning strategies, and microarray approaches.  相似文献   

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