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近年来对血管内大 B 细胞淋巴瘤的认识和管理进展

英文原题:Recent advances in understanding and management of intravascular large B-cell lymphoma.

查看英文原题

Recent advances in understanding and management of intravascular large B-cell lymphoma.

PubMed 2025/11/08(内容时间) Jpn J Clin Oncol Q3 · IF 2.5(JCR 2025)

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中文摘要

血管内大B细胞淋巴瘤(IVLBCL)是一种罕见的结外大B细胞淋巴瘤,其特征为肿瘤细胞在全身器官小血管腔内增殖。由于常表现为发热和全身乏力等非特异性症状,诊断仍然具有挑战性。自其被列为世界卫生组织第4版分类中的独立疾病实体以来,对IVLBCL的认识有所提高,诊断准确性也随之改善。然而,仍有诊断延迟或诊断困难的患者被不断报道。近期遗传学研究已发现与IVLBCL相关的复发性遗传学异常,并提示液体活检在诊断和治疗监测中的潜在应用价值。然而,尽管取得了这些进展,转化研究与临床应用之间仍存在差距,尤其是在如何将液体活检纳入临床实践方面。在治疗方面,尽管以中枢神经系统导向治疗为标准方案的化疗在初始管理中已显示出良好结局,但新兴免疫细胞疗法在IVLBCL中的疗效和安全性在很大程度上仍不明确。本文旨在综述IVLBCL认识和管理方面的最新进展,最终目标是改善IVLBCL的临床结局并推进其治疗管理。

展开英文摘要原文

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma characterized by the proliferation of tumor cells within the lumina of small vessels in systemic organs. Diagnosis remains challenging due to the frequent presentation of non-specific symptoms such as fever and general malaise.

Since its listing as a distinct disease entity in the 4th edition of the World Health Organization classification, awareness of IVLBCL has increased, leading to improvements in diagnostic accuracy. Nevertheless, patients with delayed or difficult diagnosis continue to be reported. Recent genetic studies have identified recurrent genetic abnormalities associated with IVLBCL, and the potential utility of liquid biopsy for diagnosis and treatment monitoring has been suggested.

However, despite these advances, a gap remains between translational research and clinical application, particularly regarding how liquid biopsy can be incorporated into clinical practice. Regarding treatment, although standard chemotherapy with central-nervous-system-directed therapy has demonstrated favorable outcomes in initial management, the efficacy and safety of emerging immune cell therapies in IVLBCL remain largely unknown.

This article aims to review recent advances in the understanding and management of IVLBCL, with the ultimate goal of improving clinical outcomes and advancing therapeutic management of IVLBCL.

论文信息

作者
Shimada K
单位
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.Japan
文献类型
综述
期刊
Japanese journal of clinical oncology2025 Nov 8
原文标识
PubMed 40632023 · DOI 10.1093/jjco/hyaf112