Jurnal Internasional Biologi dan manajemen limfoma efusi primer
Lymphoma primary effusion (PEL) is a rare B-cell malignancy most common in immunocompromised patients, such as people infected with HIV and patients receiving organ transplants. The main feature of PEL is neoplastic effusion in the body cavity without detecting tumor masses. The onset of this disease is associated with latent infection of human herpes virus 8 / Kaposi-related sarcoma of the herpes virus, and the normal counterpart of tumor cells is B cells with plasmablastic differentiation. Immunodeficiency conditions and absence of CD20 expression generally lead to the expectation of a lack of efficacy of anti-CD20 monoclonal antibodies; the clinical outcome of the disease remained very poor, with overall survival at 1 year ∼30%. Although recent advances in antiretroviral therapy have improved the outcomes of HIV-infected patients, the benefits are still limited to patients with PEL. Furthermore, the usual high expression of programmed death ligands 1 in tumor cells, one of the most important molecules in immune examination, results in the release of tumor cells from host immune defenses, which could be the mechanism underlying the efficacy of poor treatment. Molecularly targeted therapy for the activation pathways in PEL, including NF-κB, JAK / STAT, and phosphatidylinositol 3-kinase / AKT, has emerged to treat this difficult disease. The combination of immunological recovery from immune deficiencies, overcoming immunity escape, and more effective drug development will be very important to improve future PEL patient outcomes.