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Both bortezomib-contained chemotherapy and thalidomide combined with cyclophosphamide, doxorubicin, vincristine, and prednisone play promising roles in plasmablastic lymphoma: A case report and literature review

Clinical Lymphoma Myeloma and Leukemia

Abstract

Plasmablastic lymphoma (PBL) is a rare entity of aggressive non-Hodgkin’s lymphoma strongly associated with human immunodeficiency virus infection and oral cavity involvement. This condition is extremely rare in immunocompetent patients. Commonly used regimens are lymphoma-specific multi-agent systemic chemotherapy with or without consolidation radiation and hematopoietic stem cell transplantation. Lack of standard treatment for PBL and its poor therapeutic outcome suggested that new therapeutic approaches are urgently needed. Novel agents used in myeloma therapy are currently applied to PBL considering the immunophenotypic similarity between the two.

One emerging therapeutic option for PBL is bortezomib, a proteasome inhibitor approved for the treatment of myeloma and relapsed or refractory mantle cell lymphoma. Bortezomib has shown promising results in previously published cases. Using morphological, immunophenotypic, and cytogenetic techniques, we documented a case of gastric PBL which showed similar cytogenetic characteristics with myeloma in an immunocompetent patient. We applied myeloma chemotherapy with bortezomib and tried thalidomide combing with cyclophosphamide, doxorubicin, vincristine, and prednisone in PBL therapy. Bortezomib and thalidomide treatment elicited a remarkable and early therapeutic response. The rapidity and intensity of the response to anti-myeloma agents suggested the promising role of these drugs in PBL treatment. Anti-myeloma agents, such as bortezomib and thalidomide, should be further investigated.

Keywords: plasmablastic lymphoma, bortezomib, thalidomide, cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), human immunodeficiency virus negative, interphase fluorescence in situ hybridization (FISH).

Footnotes

1 Department of Hematology, West China Hospital, Sichuan University, Key Lab of Hematology of Sichuan Province, Chengdu, China

2 Department of Pathology, West China Hospital, Sichuan University, Chengdu, China

Correspondence to: Bing Xiang. Department of Hematology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, China 610041 E-mail address: Bing Xiang, hxmutangguo@gmail.com Fax No.: +8685423921