Hematopoietic Cell Transplantation for Plasmablastic Lymphoma: A Review

Abstract

Plasmablastic lymphoma (PBL) is recognized by the World Health Organization as a very aggressive subtype of non-Hodgkin lymphoma. It was initially described in the setting of human immunodeficiency virus (HIV) infection, but it has since been identified in immunocompetent patients, as well. PBL is characterized by CD20 negativity and is associated with Epstein-Barr virus infection. The outcome with available therapy is poor, with median survival of less than 1 year. Multiple adverse prognostic factors have been identified, including HIV-negativity, MYC gene rearrangement, high-risk international prognostic index, and not achieving complete remission after induction therapy. The role of intensification of induction chemotherapy is controversial. Novel agents have shown some activity in relapsed setting and may have a role in upfront line of treatment. The outcome for relapsed PBL is dismal. Autologous hematopoietic cell transplantation (AHCT) appears to be feasible and may produce better results than chemotherapy, but definitive data are sparse. Chemosensitivity before transplantation might be required to benefit from such therapy. Some data suggest a better outcome of PBL if consolidation with AHCT is used in first-line setting, particularly for those with high-risk disease.

A case of HIV‐negative plasmablastic lymphoma of the bone marrow with a unique immunophenotype

“…The immunophenotype, though, was more complicated. PBLs typically lose classic B‐cell markers (CD19, CD20, and PAX5) and gain plasma cell markers (CD38, CD138, and MUM1) . Our patient was negative for both the traditional B‐cell markers as well as the traditional plasma cell markers.…”

EBV-Positive Plasmablastic Lymphoma Mimicking Reactive Lymphadenopathy versus Recurrent Hodgkin Lymphoma Following Chemotherapy for Stage II Classical Hodgkin Lymphoma

“…Although PBL is known to occur in patients with history of other types of lymphoma [14][15][16] including Hodgkin lymphoma [13,16] the pathogenesis of its development in these patients is generally considered to be related to immunosuppressive (chemotherapy-related or iatrogenic) rather than Richter type high-grade lymphoma transformation [17][18][19]. PBL usually involves the oral mucosa of immune deficient patients, but can also occur in approximately 35% of immunocompetent and elderly individuals [5,17].…”

“…The prognosis of PBL is poor, with an overall median survival of 8 months [18]. Variety of treatments has been proposed for PBL [19] Cyclophosphamide, doxorubicin, vincristine, and prednisone commonly used for DLBCL is generally considered inadequate for PBL3.…”

A Case of Plasmablastic Lymphoma Achieving Complete Response and Durable Remission after Lenalidomide-Based Therapy

“…The National Comprehensive Cancer Network guidelines recommend intensive multi-agent cytotoxic chemotherapy regimens for first-line treatment; however, tolerability remains a concern with these regimens [4]. Autologous stem cell transplant is a consideration for patients who achieve remission [11]. …”