Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially av...Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.展开更多
Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr v...Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr virus(EBV)infection.The disease is especially aggressive in nature,with more than 70%mortality when diagnosed at advanced stages which is frequent and resulting from poor healthcare infrastructure and limited access to diagnostic facilities.Liquid biopsy approaches,which detect tumor-derived components in bodily fluids,offer promising potential for early,minimally invasive detection of EBV-positive BL.Emerging evidence suggests liquid biopsy methods can reduce diagnostic delays from weeks to≤48 h without compromising>85%concordance with tissue biopsy,demonstrated in Malawi and Kenyan pilot trials(2021-2023).According to the WHO-AFRO report(2023),due to administrative and cost burdens,only 15%of regional clinics are offering liquid biopsy testing as liquid biopsy test costs approximately 120/test as compared to histopathology,which costs$35.This review critically evaluates the technical and implementation challenges associated with developing liquid biopsy assays specifically tailored for BL detection in resource-limited settings across Sub-Saharan Africa.We discuss recent technological advances in circulating tumor DNA(ctDNA)analysis,EBV biomarker detection as technical validations of ctDNA and EBV marker assays have 90-95%sensitivity in early studies,and point-of-care diagnostics,alongside the logistical,economic,and sociocultural barriers to their effective implementation.Additionally,we propose strategic frameworks for overcoming these challenges through collaborative international partnerships,capacity building initiatives,and context-appropriate technology adaptation.Through all these cross-sector partnerships and approaches could transform BL outcomes by enabling stage-shift to 80%early-stage diagnoses,reducing mortality rates by 50%,potentially doubling survival rates in high-burden regions.展开更多
目的:探讨成人原发性胃肠道Burkitt样淋巴瘤的流行病学、临床病理特点、诊断和治疗.方法:利用韩国延世大学图书馆平台在Medline/Pub Med、Web of Science、Directory of Open Access Journals(DOAJ)、Springer Link等15家英文文献数据...目的:探讨成人原发性胃肠道Burkitt样淋巴瘤的流行病学、临床病理特点、诊断和治疗.方法:利用韩国延世大学图书馆平台在Medline/Pub Med、Web of Science、Directory of Open Access Journals(DOAJ)、Springer Link等15家英文文献数据库和中国知网中文期刊全文数据库中检索1995年以来发表的符合纳入条件的相关文献,共获得来自6篇文献的6例成人原发性胃肠道Burkitt样淋巴瘤的患者资料.结果:成人原发性胃肠道Burkitt样淋巴瘤主要分布在东亚的日本和中国(4例,66.7%);6例患者均为男性,平均年龄57.6岁;2例发生于回盲部,1例发生于胃,1例发生于结肠肝曲,1例发生于末端回肠,还有1例在胃和小肠同时发生;因发现腹部肿块就诊者4例,伴随B症状:体质量减轻4例;乏力2例;所有患者均行消化道内镜检查,行计算机断层扫描(computed tomography,CT)检查者5例,行B超检查者3例;行手术治疗者4例,行联合化疗者5例,行手术+术后化疗者3例;1例患者在1年内死亡;最长1例患者随访5年仍存活;6例患者中行CD20检测者4例,均为阳性;行C D10检测者6例,4例为阳性;行K i-67检测者3例,均为阳性;行B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)检测者3例,均为阴性;行CD23检测者2例,均为阴性;行CD5检测者2例,均为阴性.结论:成人原发性胃肠道Burkitt样淋巴瘤临床罕见,属于高度恶性的非霍奇金淋巴瘤,进展快,死亡率高.其临床表现缺乏特异性,在进行临床干预治疗之前,建议行全面的检查以明确诊断,最终诊断仍依赖于细针穿刺活组织检查或手术切除病理检查.治疗上应在诊断明确后尽早实施外科手术及术后的多药联合辅助化疗.临床医师应该提高对本病的认识,重视该病的临床诊治,以改善患者的预后.展开更多
基金supported by the Sponsored by Tianjin Health Research Project(Grant No.TJWJ2023ZD003)the Chinese Society of Clinical Oncology Beijing Xisike Clinical Oncology Research Foundation(Grant Nos.Y-NCJH202201-0027 and Y-2022YMJN/MS-0001).
文摘Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.
文摘Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr virus(EBV)infection.The disease is especially aggressive in nature,with more than 70%mortality when diagnosed at advanced stages which is frequent and resulting from poor healthcare infrastructure and limited access to diagnostic facilities.Liquid biopsy approaches,which detect tumor-derived components in bodily fluids,offer promising potential for early,minimally invasive detection of EBV-positive BL.Emerging evidence suggests liquid biopsy methods can reduce diagnostic delays from weeks to≤48 h without compromising>85%concordance with tissue biopsy,demonstrated in Malawi and Kenyan pilot trials(2021-2023).According to the WHO-AFRO report(2023),due to administrative and cost burdens,only 15%of regional clinics are offering liquid biopsy testing as liquid biopsy test costs approximately 120/test as compared to histopathology,which costs$35.This review critically evaluates the technical and implementation challenges associated with developing liquid biopsy assays specifically tailored for BL detection in resource-limited settings across Sub-Saharan Africa.We discuss recent technological advances in circulating tumor DNA(ctDNA)analysis,EBV biomarker detection as technical validations of ctDNA and EBV marker assays have 90-95%sensitivity in early studies,and point-of-care diagnostics,alongside the logistical,economic,and sociocultural barriers to their effective implementation.Additionally,we propose strategic frameworks for overcoming these challenges through collaborative international partnerships,capacity building initiatives,and context-appropriate technology adaptation.Through all these cross-sector partnerships and approaches could transform BL outcomes by enabling stage-shift to 80%early-stage diagnoses,reducing mortality rates by 50%,potentially doubling survival rates in high-burden regions.
文摘目的:探讨成人原发性胃肠道Burkitt样淋巴瘤的流行病学、临床病理特点、诊断和治疗.方法:利用韩国延世大学图书馆平台在Medline/Pub Med、Web of Science、Directory of Open Access Journals(DOAJ)、Springer Link等15家英文文献数据库和中国知网中文期刊全文数据库中检索1995年以来发表的符合纳入条件的相关文献,共获得来自6篇文献的6例成人原发性胃肠道Burkitt样淋巴瘤的患者资料.结果:成人原发性胃肠道Burkitt样淋巴瘤主要分布在东亚的日本和中国(4例,66.7%);6例患者均为男性,平均年龄57.6岁;2例发生于回盲部,1例发生于胃,1例发生于结肠肝曲,1例发生于末端回肠,还有1例在胃和小肠同时发生;因发现腹部肿块就诊者4例,伴随B症状:体质量减轻4例;乏力2例;所有患者均行消化道内镜检查,行计算机断层扫描(computed tomography,CT)检查者5例,行B超检查者3例;行手术治疗者4例,行联合化疗者5例,行手术+术后化疗者3例;1例患者在1年内死亡;最长1例患者随访5年仍存活;6例患者中行CD20检测者4例,均为阳性;行C D10检测者6例,4例为阳性;行K i-67检测者3例,均为阳性;行B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)检测者3例,均为阴性;行CD23检测者2例,均为阴性;行CD5检测者2例,均为阴性.结论:成人原发性胃肠道Burkitt样淋巴瘤临床罕见,属于高度恶性的非霍奇金淋巴瘤,进展快,死亡率高.其临床表现缺乏特异性,在进行临床干预治疗之前,建议行全面的检查以明确诊断,最终诊断仍依赖于细针穿刺活组织检查或手术切除病理检查.治疗上应在诊断明确后尽早实施外科手术及术后的多药联合辅助化疗.临床医师应该提高对本病的认识,重视该病的临床诊治,以改善患者的预后.
基金Specific Disease Foundationfor Lymphoma of Sun Yat-sen University Cancer Center(No.2008-00652)~~
文摘背景与目的:散发性Burkitt's淋巴瘤(sporadic Burkitt's lymphoma,sBL)少见,中国sBL的EB病毒(Epstein-Barrvirus,EBV)感染状况尚未见报道。本研究探讨广州地区sBL的临床特点、形态学特征、免疫表型及EBV的感染状况。方法:分析总结21例sBL患者的临床资料,并作一系列免疫组织化学染色确定免疫表型,EBV编码的小RNA(EBV-encoded small RNAs,EBERs)原位杂交检测EBV感染情况。结果:中山大学肿瘤防治中心2000年1月～2007年10月收治的2416例非霍奇金淋巴瘤中,明确诊断21例sBL(0.87%)。男女之比为4.25:1(17/4);中位年龄23岁。21例患者中,19例(90.48%)有淋巴结侵犯;16例(76.19%)多部位受累;12例(57.14%)临床分期为Ⅲ/Ⅳ期;15例化疗或手术加化疗患者的2年生存率为56.00%。20例形态学上表现为经典BL,另1例为伴有浆细胞样分化的BL变异型。该21例sBL主要的免疫表型为sIgM+/CD20+/CD10+/Bcl-6+/Bcl-2-[或Bcl-6+(>95%)/Bcl-2+(<10%)]/TdT-/Ki-67+100%。20例可检测病例中,11例有少数肿瘤细胞(3%～20%)表达CD5。10例肿瘤(47.62%)呈P53蛋白过表达。6例(28.57%)肿瘤细胞感染EBV,表达EBNA1和EBERs,但不表达LMP1。EBV阳性及阴性病例在形态学和免疫表型上均无显著差异。结论:广州地区sBL少见,主要见于儿童及年轻成年男性。多数病例有淋巴结的侵犯。形态学及免疫表型与地方性BL类同。28.57%病例呈EBVI型潜伏感染。
