a Department of Hematology , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China.
b Department of Pathology , Affiliated Hospital of Nantong University , Nantong , Jiangsu , China.
Cancer Biol Ther. 2018 Jul 3;19(7):549-553. doi: 10.1080/15384047.2018.1449609. Epub 2018 Apr 13.
CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) is associated with poor survival compared with CD5-negative DLBCL. The clinical characteristics of CD5+ DLBCL are different from both CD5-negative DLBCL and other CD5+ B cell lymphomas. There is currently no promising chemotherapy for CD5+ DLBCL. Herein, we report a 49-year-old Asian male with refractory CD5+ DLBCL. He complained of aggravated abdominal pain and weight loss. Computed tomography scan revealed abdominal masses, widespread lymphadenopathy, splenomegaly, and intussusception of the ileocecal junction with bowel wall thickening. Core needle aspiration biopsy of an abdominal mass was performed and immunohistochemistry revealed DLBCL of nongerminal center type. In this report, the dose-intensified R-Hyper CVAD (A) regimen as salvage therapy was introduced but failed to result in substantial improvement over the initially standard R-CHOP regimen. Next, the R-GDP regimen was administered as second-line treatment, but only resulted in a partial response. However, the addition of lenalidomide to R-GDP (R2-GDP) resulted in complete remission. The clinical features, pathogenesis, and possible mechanism of action of lenalidomide in CD5+ DLBCL have been described in the literature. The results of the present case report and literature searches indicate that CD5+ DLBCL may share a common pathway with activated B-cell like (ABC) DLBCL as determined by gene expression profiling. Lenalidomide is expected to induce favorable responses in patients with CD5+ DLBCL.
CD5 阳性（CD5+）弥漫性大 B 细胞淋巴瘤（DLBCL）与 CD5 阴性 DLBCL 相比，生存预后较差。CD5+ DLBCL 的临床特征与 CD5 阴性 DLBCL 和其他 CD5+ B 细胞淋巴瘤均不同。目前针对 CD5+ DLBCL 尚无有效的化疗方案。本文报道了一例 49 岁的亚洲男性，患有难治性 CD5+ DLBCL。他主诉腹痛加剧和体重减轻。计算机断层扫描显示腹部肿块、广泛的淋巴结病、脾肿大和回盲部肠套叠伴有肠壁增厚。对腹部肿块进行了芯针穿刺活检，免疫组化显示非生发中心型 DLBCL。本文中，采用强化剂量 R-HyperCVAD（A）方案作为挽救性治疗，但与最初的标准 R-CHOP 方案相比，并未显著改善。随后，给予 R-GDP 方案作为二线治疗，但仅部分缓解。然而，在 R-GDP 中添加来那度胺（R2-GDP）后则达到完全缓解。文献中描述了 CD5+ DLBCL 的临床特征、发病机制和来那度胺可能的作用机制。本病例报告和文献检索的结果表明，CD5+ DLBCL 可能与激活 B 细胞样（ABC）DLBCL 具有共同的途径，这是通过基因表达谱确定的。来那度胺有望在 CD5+ DLBCL 患者中诱导良好的反应。
