4.4 Review

Primary mediastinal large B cell lymphoma

Journal

THORACIC CANCER
Volume 12, Issue 21, Pages 2831-2837

Publisher

WILEY
DOI: 10.1111/1759-7714.14155

Keywords

diagnosis; drug therapy; immunotherapy; primary mediastinal large B-cell lymphoma

Funding

  1. Application Bases and Advanced Technology Research Program of Tianjin China [09JCYBJC11200, 14JCYBJC27200]
  2. Key Technology Research and Development Program of Tianjin China [18ZXDBSY00140]
  3. National Natural Science Foundation of China [81170472, 32100656]

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PMBCL is an aggressive large B cell lymphoma mainly expressing B cell surface molecules, with diagnosis relying on pathological features, imaging examination, and clinical features. The commonly used therapeutic regimens include R-CHOP and R-EPOCH, with radiotherapy being beneficial in some patients but potentially leading to long-term toxicity. Research on novel therapies, such as CAR-T cell therapy and anti-PD-1 drugs, is ongoing, with the need for larger randomized controlled trials. PET-CT is mainly used to assess treatment response and guide subsequent treatment strategies.
Primary mediastinal large B cell lymphoma (PMBCL) is an aggressive large B cell lymphoma originating in the mediastinum, that mainly expresses B cell surface molecules, such as CD19, CD20, CD22, andCD79a. Clinically, they are characterized by rapidly increasing anterior mediastinal masses, which can cause compression of the surrounding tissues. The diagnosis of PMBCL mainly depends on the pathological features, imaging examination and clinical features. Currently, the most commonly used therapeutic regimens are R-CHOP and R-EPOCH. Radiotherapy is beneficial in some patients, but it can also lead to long-term toxicity. The research and development of novel therapies are ongoing, and some studies have achieved encouraging results, including those conducted on chimeric antigen receptor-modified T (CAR-T) cell therapy and anti-PD-1 drugs. However, randomized controlled trials with larger sample sizes are still needed. Positron emission tomography-computed tomography (PET-CT) is mainly used to assess the curative effect after treatment and to guide the subsequent treatment strategy.

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