双表达淋巴瘤的诊断及治疗进展

Progress in diagnosis and treatment of double expressor lymphoma

2016年世界卫生组织(WHO)分类修订版中把与染色体重排无关的Myc和Bcl-2蛋白的过度表达定义为双表达淋巴瘤(double expressor lymphoma,DEL),但其并非一个独立的诊断类别,仍属于DLBCL非特指型(DLBCL not otherwise specified,DLB⁃CL-NOS)。随着对该疾病认识的不断深入,对DEL患者的预后分析及治疗方案等有很多研究,如Myc和Bcl-2蛋白过表达不同阳性阈值、P53蛋白过表达、CD5蛋白过表达及血清白蛋白水平对其预后的判断价值,以及强化化疗、造血干细胞移植、靶向治疗、免疫治疗等治疗方法的研究探索。本文旨在对DEL患者的预后因素及治疗进展进行综述。

In the revised 2016 WHO Classification of Lymphoid Neoplasms,double expressor lymphoma(DEL)is defined as a diffuse large B-cell lymphoma(DLBCL)with increased expression of Myc and Bcl-2 proteins which is uncorrelated with chromosomal rearrangements.DEL is not an independent diagnostic category.It is still considered to be a DLBCL not otherwise specified(DLBCL-NOS).Many studies on the prognosis and treatment of DEL patients have deepened our understanding of this disease,including studies of the impact of different cut-offs for Myc and Bcl-2 protein overexpression;the prognostic value of TP53,CD5,and serum albumin;and explorations of intensive chemotherapy,hematopoietic stem cell transplantation,targeted therapies,immunotherapies,etc.The purpose of this review is to discuss the prognostic factors and current therapeutic approaches for patients with DEL.