Patil Sneha, Rajput Sudarshan, Patil Shaktipal, Mhaiskar Amrapali
Department of Pharmacology, H. R. Patel Institute of Pharmaceutical Education and Research, Karwand naka, Shirpur, Maharashtra 425405, India.
Department of Pharmacology, H. R. Patel Institute of Pharmaceutical Education and Research, Karwand naka, Shirpur, Maharashtra 425405, India; Department of Pharmacology, Nootan Pharmacy College, Sankalchand Patel University, Visnagar, Gujarat 384315, India.
Pathol Res Pract. 2025 Jul;271:156036. doi: 10.1016/j.prp.2025.156036. Epub 2025 May 26.
B-cell lymphomas (BCL) represent a heterogeneous group of blood cancers originating from B-lymphocytes, characterized by diverse clinical manifestations and molecular characteristics. This review highlights recent progress in understanding their pathogenesis, diagnostic approach advancements, and therapeutic strategies developments. Key genetic alterations such as chromosomal translocations (e.g., t(14;18), MYC rearrangements), mutations in tumor suppressor genes like TP53, and disruptions in critical signaling pathways including B-cell receptor (BCR), NF-κB, PI3K/AKT, and JAK/STAT are central to disease development. Additionally, non-coding RNAs, especially microRNAs, play crucial regulatory roles in lymphomagenesis. Innovations in diagnostics, such as liquid biopsy technologies using cell-free DNA (cfDNA) and circulating tumor DNA (ctDNA), have enhanced early detection, disease monitoring, and prognostication. Concurrently, molecular biomarkers and emerging classifiers improve risk assessment and guide treatment decisions. Treatment approaches have evolved beyond traditional chemotherapy and radiotherapy. Targeted therapies such as monoclonal antibodies, kinase inhibitors, bispecific antibodies, and CAR-T cell therapies have shown particular promise in relapsed or refractory cases. Stem cell transplantation remains a valuable option for select patients. Additionally, novel agents targeting epigenetic mechanisms and tumor angiogenesis are under active investigation. This review underscores both the significant advancements and ongoing challenges, such as therapy resistance and adverse effects. The integration of molecular diagnostics with precision-targeted and immune-based therapies is key to advancing personalized care. Future research should aim to characterize tumor heterogeneity better and optimize therapeutic strategies to improve outcomes for patients with B-cell lymphomas.
B细胞淋巴瘤（BCL）是一类起源于B淋巴细胞的异质性血癌，具有多样的临床表现和分子特征。本综述重点介绍了在理解其发病机制、诊断方法进展和治疗策略发展方面的最新进展。关键的基因改变，如染色体易位（如t(14;18)、MYC重排）、肿瘤抑制基因（如TP53）的突变以及关键信号通路（包括B细胞受体（BCR）、NF-κB、PI3K/AKT和JAK/STAT）的破坏，是疾病发展的核心。此外，非编码RNA，尤其是微小RNA，在淋巴瘤发生过程中发挥着关键的调节作用。诊断方面的创新，如使用游离DNA（cfDNA）和循环肿瘤DNA（ctDNA）的液体活检技术，增强了早期检测、疾病监测和预后评估。同时，分子生物标志物和新兴分类器改善了风险评估并指导治疗决策。治疗方法已超越传统的化疗和放疗。单克隆抗体、激酶抑制剂、双特异性抗体和CAR-T细胞疗法等靶向治疗在复发或难治性病例中显示出特别的前景。干细胞移植对特定患者仍然是一个有价值的选择。此外，针对表观遗传机制和肿瘤血管生成的新型药物正在积极研究中。本综述强调了重大进展和持续存在的挑战，如治疗耐药性和不良反应。将分子诊断与精准靶向和基于免疫的治疗相结合是推进个性化医疗的关键。未来的研究应旨在更好地表征肿瘤异质性并优化治疗策略，以改善B细胞淋巴瘤患者的治疗效果。
