Durani Urshila, Ansell Stephen M
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA.
Leuk Lymphoma. 2021 Dec;62(13):3078-3086. doi: 10.1080/10428194.2021.1953010. Epub 2021 Jul 21.
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity, and cell surface cluster of differentiation (CD) 5 expression may represent a distinct subset. Here, we provide a narrative review of CD5+ DLBCL to understand its clinical implications. Between 5-10% of DLBCL express CD5, making it an uncommon subset. Studies have variably shown that CD5+ DLBCL may be associated with increased age, high lactate dehydrogenase, B symptoms, extra-nodal sites, higher International Prognostic Index score, and advanced stage. CD5+ DLBCLs are more likely to express Bcl-2, MYC, and MUM1; a large proportion exhibit an activated B-cell (ABC)-like phenotype. The balance of studies generally supports an independent prognostic value of CD5 in DLBCL While more aggressive first-line regimens have been advocated for CD5+ DLBCL, including dose-adjusted R-EPOCH and autologous stem cell transplant, evidence to support these approaches is lacking; further study is warranted to identify the optimal treatment strategy for this disease entity.
弥漫性大B细胞淋巴瘤（DLBCL）是一种异质性疾病，细胞表面分化簇（CD）5表达可能代表一个独特的亚群。在此，我们对CD5阳性DLBCL进行叙述性综述，以了解其临床意义。5%至10%的DLBCL表达CD5，使其成为一个不常见的亚群。研究结果不一，显示CD5阳性DLBCL可能与年龄增加、乳酸脱氢酶升高、B症状、结外部位、较高的国际预后指数评分以及晚期有关。CD5阳性DLBCL更有可能表达Bcl-2、MYC和MUM1；很大一部分表现出活化B细胞（ABC）样表型。总体而言，多数研究支持CD5在DLBCL中具有独立的预后价值。虽然有人主张对CD5阳性DLBCL采用更积极的一线治疗方案，包括剂量调整的R-EPOCH和自体干细胞移植，但缺乏支持这些方法的证据；有必要进一步研究以确定针对该疾病实体的最佳治疗策略。
