Aggressive lymphoma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Synonyms and Keywords: Intermediate-grade lymphoma; High-grade lymphoma

Overview

Aggressive lymphoma may be classified according to cell type into the following: diffuse large cell lymphoma, mediastinal large B-cell lymphoma, follicular large cell lymphoma (grade 3), anaplastic large cell lymphoma (CD30+), extranodal NK/T-cell lymphoma, angioimmunoblastic T-cell lymphoma, hepatosplenic T-cell lymphoma, enteropathy-type T-cell lymphoma, intravascular large B-cell lymphoma, Burkitt lymphoma, precursor B- or T-cell lymphoblastic lymphoma, primary CNS lymphoma, adult T-cell leukemia, mantle cell lymphoma, polymorphic post-transplant lymphoproliferative disorder (PTLD), AIDS-related lymphoma, true histiocytic lymphoma, primary effusion lymphoma, and aggressive NK-cell leukemia. Most common type of aggressive cancer is diffuse large B cell lymphoma (DLBCL). Genetic causes for aggressive lymphoma are the t(14;18) translocation, 37,50 deletion of the tumor suppressor PTEN, amplification of the microRNA cluster miR-17-92 (which down-regulates PTEN 55), and p53 mutations. Prognosis is generally predicted by the International Prognostic Index (IPI). The mainstay of therapy for aggressive lymphoma is intensive combination chemotherapy.

Classification

  • Aggressive lymphoma may be classified according to cell type into the following groups:[1]

Pathophysiology

  • Most common type of aggressive cancer is diffuse large B cell lymphoma (DLBCL).
  • Genetic causes for aggressive lymphoma are the t(14;18) translocation, 37,50 deletion of the tumor suppressor PTEN, amplification of the microRNA cluster miR-17-92 (which down-regulates PTEN 55), and p53 mutations.

Causes

  • Genetic causes for aggressive lymphoma are the t(14;18) translocation, 37,50 deletion of the tumor suppressor PTEN, amplification of the microRNA cluster miR-17-92 (which down-regulates PTEN 55), and p53 mutations.

Natural History, Complications and Prognosis

Treatment

Medical Therapy

  • The mainstay of therapy for aggressive lymphoma is intensive combination chemotherapy.

References

  1. Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES (2011). "The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications.". Blood. 117 (19): 5019–32. PMC PMC3109529Freely accessible Check |pmc= value (help). PMID 21300984. doi:10.1182/blood-2011-01-293050. 

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