Plasmablastic lymphoma - single centre experience with infusional EPOCH chemotherapy

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Plasmablastic lymphoma (PBL) is a rare, aggressive subtype of large B-cell non-Hodgkin lymphoma.
• Initially identified in HIV-positive individuals, PBL is also observed in immune-competent populations.
• Recognized as a distinct entity in the 2008 WHO lymphoma classification.

Purpose of the Study:

• To retrospectively analyze clinical features, treatment strategies, and outcomes of PBL patients.
• To evaluate the efficacy of different chemotherapy regimens, including infusional EPOCH.
• To identify prognostic factors influencing event-free survival (EFS) and overall survival (OS).

Main Methods:

• Retrospective analysis of 25 PBL patients diagnosed between January 2012 and December 2018.
• Data collection included clinical features, HIV status, treatment details, and outcomes.
• Survival analysis performed using Kaplan-Meier and Log Rank tests.

Main Results:

• The median age of patients was 41 years, with 76% being male and 72% HIV-positive.
• Stage IV disease (76%) and extranodal involvement (96%) were common presentations.
• Infusional EPOCH chemotherapy in 13 patients resulted in an 80% overall response rate for those treated with curative intent.
• Median EFS and OS for the entire cohort were 5.9 and 12.4 months, respectively.
• Factors adversely affecting survival included age > 40, high IPI, and non-curative treatment intent.

Conclusions:

• Plasmablastic lymphoma typically presents as advanced-stage disease with extranodal involvement, predominantly in immune-deficient individuals.
• Infusional EPOCH chemotherapy is a potentially effective treatment, offering long-term remission possibilities.
• Age, IPI score, and treatment intent are critical prognostic indicators for PBL outcomes.