Research progress on primary mediastinal large B-cell lymphoma

Abstract

Primary mediastinal large B-cell lymphoma (PMBCL) has specific phenotypical features, pathological features and clinical presentation. PMBCL patients are predominantly female and typically present early stage disease and mediastinal involvement. Due to the lack of randomized studies, most patients with PMBCL usually receive combination chemotherapy with consolidation IF-RT. Considering IF-RT can improve the complete remission rates and recurrence-free survival, the combined therapy achieved good results. The different chemotherapeutic regimens were used in clinical practice of different institutions and clinicians, including CHOP or CHOP-like, intensive chemotherapy or the third-generation regimens. Recent studies have showed promising outcomes when rituximab is added to doxorubicin-containing chemotherapy. Patients treated with R-CHOP with radiotherapy had significantly better local control rates compared with R-CHOP without radiotherapy, especially for bulky diseases. Intensity-modulated radiation therapy offers excellent target coverage, favorable outcome and minimal toxicity in PMBCL. Although the majority of patients with PMBCL receive radiotherapy following chemotherapy, few studies have specifically addressed the role of consolidation radiotherapy for the treatment of PMBCL. The prognostic importance of rituximab and radiotherapy has not been clearly defined in patients with PMBCL. Heterogeneous treatment options and small number of patients have made it difficult to draw definitive conclusions about the potential advantages of rituximab and radiotherapy in patients with PMBCL. Key words: Neoplasms, primary; Mediastinal neoplasms; Lymphoma, B-cell; Drug therapy; Radiotherapy; Rituximab; Prognosis