Gouveia GR, Siqueira SAC, Pereira J. Pathophysiology and molecular aspects of diffuse large B-cell lymphoma.
Rev Bras Hematol Hemoter 2013;
34:447-51. [PMID:
23323070 PMCID:
PMC3545433 DOI:
10.5581/1516-8484.20120111]
[Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 09/28/2012] [Indexed: 11/27/2022] Open
Abstract
Diffuse large B-Cell lymphoma is the most common subtype of non-Hodgkin lymphoma in
the West. In Brazil, it is the fifth cause of cancer, with more than 55,000 cases and
26,000 deaths per year. At Hospital das Clínicas da Faculdade de Medicina da
Universidade de São Paulo - HCFMUSP, diffuse large B-Cell lymphoma represents
49.7% of all non-Hodgkin lymphoma cases. Initially, the classification of non-Hodgkin
lymphoma was based on morphology, but advances in immunology and molecular medicine
allowed the introduction of a biological classification for these diseases. As for
other cancers, non-Hodgkin lymphoma involves patterns of multifactorial pathogenesis
with environmental factors, as well as genetic, occupational and dietary factors,
contributing to its development. Multiple lesions involving molecular pathways of
B-cell proliferation and differentiation may result in the activation of oncogenes
such as the BCL2, BCL6, and MYC genes and the inactivation of tumor suppressor genes
such as p53 and INK4, as well as other important transcription factors such as OCT-1
and OCT-2. A dramatic improvement in survival was seen after the recent introduction
of the anti-CD20 monoclonal antibody. The association of this antibody to the
cyclophosphamide, hydroxydaunorubicin, oncovin and prednisolone (CHOP) regimen has
increased overall survival of diffuse large B-Cell lymphoma and follicular lymphoma
patients by 20%. However, 50% of all diffuse large B-Cell lymphoma patients remain
incurable, creating a demand for more research with new advances in treatment. Thus,
it is important to know and understand the key factors and molecular pathways
involved in the pathogenesis of diffuse large B-Cell lymphoma.
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