《原发纵隔大B细胞淋巴瘤诊治中国专家共识(2024年版)》解读

徐兵; 赵海军

doi:10.13201/j.issn.1004-2806.2024.05.002

《原发纵隔大B细胞淋巴瘤诊治中国专家共识(2024年版)》解读

徐兵^1, ,,
赵海军¹

- 厦门大学附属第一医院，厦门大学血液病学系，厦门市血液病质控中心，厦门市血液治疗精准诊治重点实验室(福建厦门，361003)

详细信息

通讯作者: 徐兵, E-mail: xubingzhangjian@126.com

中图分类号: R733.4

收稿日期: 2024-04-15

刊出日期: 2024-05-01

Interpretation of Chinese expert consensus on the diagnosis and management of primary mediastinal large B-cell lymphoma(2024)

XU Bing^1, ,,
ZHAO Haijun¹

- Department of Hematology, the First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen Hematology Medical Quality Control Center, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, 361003, China

More Information

Corresponding author: XU Bing, E-mail: xubingzhangjian@126.com

Received Date: 15 April 2024

Publish Date: 01 May 2024

摘要

摘要: 原发纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma，PMBL)是一种原发于纵隔的侵袭性大B细胞淋巴瘤，具有独特的临床、病理及分子学特征。近年来，对PMBL发病机制的认识、诊断及治疗均有不同程度的进展，特别是新药治疗领域取得了较大突破。为提高我国临床医师对PMBL的诊断及治疗水平，中华医学会血液病学分会淋巴细胞疾病学组和中国临床肿瘤学会抗淋巴瘤联盟组织相关专家，制订了《原发纵隔大B细胞淋巴瘤诊治中国专家共识(2024年版)》。为更好地指导临床实践，文章拟对该共识的诊断及个体化分层治疗部分进行解读。
- 原发纵隔大B细胞淋巴瘤 /
- 专家共识 /
- 个体化分层治疗
Abstract: Primary mediastinal large B-cell lymphoma(PMBL) is an aggressive B-cell lymphoma that is thought to arise from thymic(medullary) B cells and has unique clinicopathologic and molecular features. In recent years, the understanding of the pathogenesis and treatment of PMBL has been updated to varying degrees, particularly in the area of new drug therapy. In order to improve the diagnosis and treatment of PMBL in China, the Lymphocyte Disease Group of the Chinese Medical Association(CMA) and the Anti-Lymphoma Alliance of the Chinese Society of Clinical Oncology commissioned a group of experts to formulate the "Chinese expert consensus on the diagnosis and management of primary mediastinal large B-cell lymphoma(2024)". To better guide clinical practice, this paper intends to interpret the diagnostic part and individualized stratified treatment of this consensus.
- primary mediastinal large B-cell lymphoma /
- expert consensus /
- individualized stratified treatment

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参考文献(17)

[1]	李小秋, 李甘地, 高子芬, 等. 中国淋巴瘤亚型分布: 国内多中心性病例10002例分析[J]. 诊断学理论与实践, 2012, 11(2): 111-115. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDLS201202007.htm
[2]	Liu X, Deng T, Guo X, et al. A retrospective analysis of outcomes for primary mediastinal large B-cell lymphoma treated with RCHOP followed by radiotherapy or front-line autologous stem cell transplantation[J]. Hematology, 2017, 22(5): 258-264. doi: 10.1080/10245332.2016.1258846
[3]	Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms[J]. Leukemia, 2022, 36(7): 1720-1748. doi: 10.1038/s41375-022-01620-2
[4]	Pittaluga S, Nicolae A, Wright GW, et al. Gene Expression Profiling of Mediastinal Gray Zone Lymphoma and Its Relationship to Primary Mediastinal B-cell Lymphoma and Classical Hodgkin Lymphoma[J]. Blood Cancer Discov, 2020, 1(2): 155-161. doi: 10.1158/2643-3230.BCD-20-0009
[5]	Hayden AR, Tonseth P, Lee DG, et al. Outcome of primary mediastinal large B-cell lymphoma using R-CHOP: impact of a PET-adapted approach[J]. Blood, 2020, 136(24): 2803-2811. doi: 10.1182/blood.2019004296
[6]	Dunleavy K, Pittaluga S, Maeda LS, et al. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma[J]. N Engl J Med, 2013, 368(15): 1408-1416. doi: 10.1056/NEJMoa1214561
[7]	Vitolo U, Seymour JF, Martelli M, et al. Extranodal diffuse large B-cell lymphoma(DLBCL)and primary mediastinal B-cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up[J]. Ann Oncol, 2016, 27(suppl 5): 91-102.
[8]	Zelenetz AD, Gordon LI, Chang JE, et al. NCCN Guidelines^® Insights: B-Cell Lymphomas, Version 6.2023[J]. J Natl Compr Canc Netw, 2023, 21(11): 1118-1131. doi: 10.6004/jnccn.2023.0057
[9]	Cwynarski K, Marzolini M, Barrington SF, et al. The management of primary mediastinal B-cell lymphoma: a British Society for Haematology Good Practice Paper[J]. Br J Haematol, 2019, 185(3): 402-409. doi: 10.1111/bjh.15731
[10]	Noerenberg D, Briest F, Hennch C, et al. Genetic Characterization of Primary Mediastinal B-Cell Lymphoma: Pathogenesis and Patient Outcomes[J]. J Clin Oncol, 2024, 42(4): 452-466. doi: 10.1200/JCO.23.01053
[11]	Camus V, Rossi C, Sesques P, et al. Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma: a LYSA study[J]. Blood Adv, 2021, 5(19): 3862-3872. doi: 10.1182/bloodadvances.2021004778
[12]	Kuruvilla J, Pintilie M, Tsang R, et al. Salvage chemotherapy and autologous stem cell transplantation are inferior for relapsed or refractory primary mediastinal large B-cell lymphoma compared with diffuse large B-cell lymphoma[J]. Leuk Lymphoma, 2008, 49(7): 1329-1336. doi: 10.1080/10428190802108870
[13]	Zinzani PL, Pellegrini C, Chiappella A, et al. Brentuximab vedotin in relapsed primary mediastinal large B-cell lymphoma: results from a phase 2 clinical trial[J]. Blood, 2017, 129(16): 2328-2330. doi: 10.1182/blood-2017-01-764258
[14]	Vassilakopoulos TP, Panitsas F, Mellios Z, et al. Incidence and risk factors for central nervous system relapse in patients with primary mediastinal large B-cell lymphoma in the rituximab era[J]. Hematol Oncol, 2023, 41(1): 97-107. doi: 10.1002/hon.3096
[15]	Neelapu SS, Locke FL, Bartlett NL, et al. Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma[J]. N Engl J Med, 2017, 377(26): 2531-2544. doi: 10.1056/NEJMoa1707447
[16]	Zinzani PL, Santoro A, Gritti G, et al. Nivolumab combined with brentuximab vedotin for R/R primary mediastinal large B-cell lymphoma: a 3-year follow-up[J]. Blood Adv, 2023, 7(18): 5272-5280.
[17]	Mei Q, Zhang W, Liu Y, et al. Camrelizumab Plus Gemcitabine, Vinorelbine, and Pegylated Liposomal Doxorubicin in Relapsed/Refractory Primary Mediastinal B-Cell Lymphoma: A Single-Arm, Open-Label, Phase Ⅱ Trial[J]. Clin Cancer Res, 2020, 26(17): 4521-4530.