伴TP53基因异常的弥漫大B细胞淋巴瘤的研究进展

Research progress of diffuse large B-cell lymphoma with TP53 gene abnormality

弥漫大B细胞淋巴瘤(DLBCL)是一种高度异质性的侵袭性恶性肿瘤,影响因素繁多,其中TP53突变被认为是DLBCL预后不良的独立因素,常提示DLBCL对一线免疫化疗不敏感、易表现为难治或复发,也无法通过DA-EPOACH-R等强化化疗方案获得生存受益。目前针对TP53基因异常的形式对DLBCL发病、治疗抵抗机制以及治疗方案的探索仍在继续,已有的研究表明,一些新药的加入,如HDAC抑制剂单药或者联合用药,以及新的治疗策略,如CAR-T细胞治疗等均为伴TP53突变的DLBCL的治疗开辟了新途径。虽然其中一些策略显示了初步的改善效果,对疾病的实际获益以及安全性仍在进一步的探索中。

Diffuse large B-cell lymphoma(DLBCL) is a highly heterogeneous aggressive malignant tumor with many influencing factors.Among them,TP53 mutation is considered to be an independent factor for the poor prognosis of DLBCL,which often indicates that DLBCL is not sensitive to first-line immunochemotherapy,prone to it manifests as refractory or relapsed,and it cannot obtain survival benefit through intensive chemotherapy regimens such as DA-EPOACH-R.At present,the exploration of the pathogenesis of DLBCL in the form of TP53 gene abnormality,as well as the mechanism of treatment resistance and the treatment of DLBCL with TP53 gene abnormality is still going on.Existing studies have shown that the addition of some new drugs,such as HDAC inhibitors alone or in combination,and new therapeutic strategies,such as CAR-T cell therapy,have opened up new avenues for the treatment of DLBCL with TP53 mutations.Although some of these strategies have shown initial improvement effects,the actual benefit and safety of the disease are still being further explored.