Blood Res  
HIV-negative plasmablastic lymphoma: report of 8 cases and a comprehensive review of 394 published cases
Ya-Jun Li1,2†, Ji-Wei Li3,4,5†, Kai-Lin Chen2,6†, Jin Li1,2, Mei-Zuo Zhong7, Xian-Ling Liu8, Ping-Yong Yi1,2, Hui Zhou1,2
1Department of Lymphoma and Hematology, Hunan Cancer Hospital, 2The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, 3Department of Pathology, Fudan University Shanghai Cancer Center, 4Department of Oncology, Shanghai Medical College, Fudan University, 5Institute of Pathology, Fudan University, Shanghai, 6Key Laboratory of Translational Radiation Oncology, Hunan Province, Department of Radiotherapy, Hunan Cancer Hospital, 7Department of Oncology, Xiangya Hospital, Central South University, 8Cancer Center of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Correspondence to: Hui Zhou, M.D.
Department of Lymphoma and Hematology, Hunan Cancer Hospital, 283 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China

These authors contributed equally to this work.
Published online: March 24, 2020.
© The Korean Journal of Hematology. All rights reserved.

Background: Human immunodeficiency virus (HIV)-negative plasmablastic lymphoma (PBL) is a rare entity of diffuse large B-cell lymphoma (DLBCL). The clinicopathological features of and optimal treatment for HIV-negative PBL remain largely unknown.
Methods: To gain insight into this distinct lymphoma, we summarized the clinicopathologic characteristics of 8 unpublished HIV-negative PBLs and performed a comprehensive review of 394 published cases.
Results: Of the 8 unpublished PBLs, the median patient age was 53.0 years. Four patients presented with stage IV disease. All 8 patients showed a plasma cell-like immunophenotype. Of the six patients who received anthracycline-based chemotherapy, including two who received bortezomib, three patients achieved a continuous complete response, two patients died due to disease progression, and one patient was lost to follow-up. The other two patients achieved continuous complete response after receiving chemotherapy combined with radiotherapy and surgery. Of the 402 patients, the majority were male, with a mean age of 58.0 years. EBV infection was detected in 55.7% of the patients. The median survival times of the patients who received CHOP or CHOP-like regimens and intensive regimens were not reached and 23.0 months, respectively, and the intensive regimen did not improve the survival outcome (P=0.981). Multivariate analysis showed that EBER remained the only independent factor affecting overall survival (OS).
Conclusions: HIV-negative PBL is a distinct entity with a predilection for elderly and immunosuppressed individuals. Intensive chemotherapy had no apparent survival benefits over the CHOP regimen in terms of OS; the prognosis of this disease is poor with current chemotherapy methods, and treatment remains a challenge.
Keywords: Clinicopathological features, Plasmablastic lymphoma, HIV negative, Treatment, Prognosis


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