title: Human immunodeficiency virus-negative plasmablastic lymphoma: a comprehensive analysis of 114 cases.
abstract: Human immunodeficiency virus-negative plasma-blastic lymphoma (PBL) is an extremely rare entity. Its clinicopathological features, optimal treatment strategy and prognostic factors remain obsure. An extensive search was performed in the English language literature within the Pubmed database using the key words: 'plasmablastic lymphoma and human immunodeficiency virus-negative or immunocompetent'. Data from 114 patients from 52 articles were analyzed. The mean patient age at diagnosis was 58.90 years (range, 2-86). HIV-negative PBL showed a predilection for elderly individuals (patients older than 60 years, 56.14%) and affected more males than females (M:F, 2.29:1). Ann Arbor stage IV patients accounted for 39.22% while bone marrow involvement was less frequent (12.79%). The Ki-67 index was high with a mean expression of 83%. Epstein-Barr virus (EBV) infection was common being positive in 58.70% of the patients while herpesvirus-8 (HHV-8) infection was rare being positive in only 7.55% of the patients. Immunosuppression was noted in 28.16% of patients. The median overall survival (OS) was 19 months. The 1- and 2-year survival rates were 52.3 and 45.3%, respectively. Age, gender and primary site showed no strong relationship with OS while Immunosuppression, Ann Arbor stage IV and EBV negativity were able to predict a poorer OS. Either complete remission (CR) or partial remission (PR) was superior to the refractory group in OS (P<0.0001 and P=0.0066, respectively). For stage Ⅰ patients, the application of radiotherapy did not improve the OS. In conclusion, HIV-negative PBL is a distinct entity likely occurring in elderly and immunosuppressed individuals. Immunosuppression status, Ann Arbor stage IV, EBV negativity and refractory to treatment are poor prognostic factors of OS in HIV-negative PBL.
authors.affiliation: Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Bailong
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Hand Surgery, The First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Chengcheng
authors.initials: C
authors.lastname: Xia
authors.affiliation: Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Dong
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D005260:Female; D018023:HIV Seronegativity; D006566:Herpesviridae Infections / Q000453:epidemiology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D016377:Organ Transplantation; D000069293:Plasmablastic Lymphoma / Q000453:epidemiology* / Q000628:therapy / Q000821:virology; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D017678:Sex Distribution; D055815:Young Adult