复发/难治性弥漫大B细胞淋巴瘤的分子诊疗进展

Advances in the Molecular Diagnosis and Therapy of Relapsed/Refractory Diffuse Large B-cell Lymphoma——Review

弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)是成人非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)最常见的病理类型,具有侵袭性,约1/3患者为难治型或最终复发。根据其基因异质性,可将DLBCL分为3种主要的分子亚型:生发中心B细胞型(germinal center B-cell Like,GCB)、活化B细胞型(activated B-cell like,ABC)和原发性纵隔B细胞淋巴瘤(primary mediastinal B-cell lymphoma,PMBL)。这些分子亚型分别起源于B细胞分化的不同阶段,其致病机制各异。因此,以DLBCL不同亚型特异性基因为作用靶点的治疗方法,较传统化疗方案更为精准,这无疑为治疗复发/难治性DLBCL带来了新的希望。本文就DLBCL三种亚型的诊断和治疗进展作一综述。

Diffuse large B-cell lymphoma （DLBCL） is biologically aggressive and most common pathological type of non-Hodgkin＇s lymphoma （NHL）, and about one-third of these patients are refractory or relapsed ultimately. Based on the molecular heterogeneity, DLBCL can be divided into 3 main molecular subtypes： germinal center B-cell like （GCB）, activated B-cell like （ABC） and primary mediastinai B-cell lymphoma （PMBL）. Arising from B cells at distinct stages of differentiation, these subtypes are also diverse in mechanisms of oncogenic activation. So targeting specific oncogene addictions within the DLBCL subtypes offers a more-precise approach to therapy in comparison with the traditional chemotherapies, undoubtedly bringing a bright hope for the treatment of relapsed/refractory DLBCL. In this article, the advances in diagnosis and therapy of GCB-DLBCL, ABC-DLBCL and PMBL relapsed/refractory diffuse large B-cell lymphoma are summarized.