Department of Pathology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, Jiangsu 215000, China.
Department of Hematopathology, MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 72, Houston, TX 77030, USA.
Biochim Biophys Acta Rev Cancer. 2018 Apr;1869(2):85-96. doi: 10.1016/j.bbcan.2018.01.001. Epub 2018 Jan 11.
Over half of patients with diffuse large B-cell lymphoma (DLBCL) can be cured by standard R-CHOP treatment (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). However, the remaining patients are refractory and ultimately succumb to progressive or relapsed disease. During the past decade, there has been significant progress in the understanding of molecular mechanisms in DLBCL, largely owing to collaborative efforts in large-scale gene expression profiling and deep sequencing, which have identified genetic alterations critical in lymphomagenesis through activation of key signaling transduction pathways in DLBCL. These discoveries have not only led to the development of targeted therapies, including several currently in clinical trials, but also laid a solid foundation for the future identification of more effective therapies for patients not curable by R-CHOP. This review summarizes the recent advances in our understanding of the molecular characterization and pathogenesis of DLBCL and new treatment directions.
超过一半的弥漫性大 B 细胞淋巴瘤（DLBCL）患者可以通过标准的 R-CHOP 治疗（利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松）治愈。然而，其余的患者是难治性的，最终会死于进行性或复发性疾病。在过去的十年中，对 DLBCL 分子机制的理解取得了重大进展，这主要归功于大规模基因表达谱和深度测序的合作努力，这些研究通过激活关键信号转导通路，确定了在淋巴瘤发生中起关键作用的遗传改变。这些发现不仅导致了靶向治疗的发展，包括目前正在临床试验中的几种治疗方法，而且为未来确定更多针对 R-CHOP 不可治愈的患者的有效治疗方法奠定了坚实的基础。这篇综述总结了我们对 DLBCL 的分子特征和发病机制的最新认识，以及新的治疗方向。
