Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, with significant invasive and heterogeneous pathological morphology and clinical manifestations. In recent years, genomic analysis has yielded different molecular profile subsets, thus explaining the heterogeneity of DLBCL and enabling personalized precision therapy. This review summarizes the complex biology of DLBCL and discusses the potential impact of pathological classification on precision therapy of DLBCL.

Objective To explore the presence of myeloid-derived suppressor cells (MDSC) in patients with non-Hodgkin lymphoma (NHL) and its clinical value. Methods Peripheral blood samples were collected from 69 NHL patients and 21 healthy controls admitted in Jilin Cancer Hospital from January 2014 to February 2015. Flow cytometry was conducted to identify unique cell surface markers of MDSC using antibodies against CD11b, CD33, CD14 or HLA-DR. MDSC were enriched by immunomagnetic beads, then arginase 1 (Arg-1), inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) in which were detected by real time-PCR. In vitro, cell proliferation assay was used to test T cell function. Statistical analysis was used to explore the correlation between MDSC and clinical features. Results There were a high level of CD11b+CD14+CD33+cells in peripheral blood of NHL patients. The morphology of the cells belonged to mononuclear cells. The ratio of monocytic CD11b+CD14+CD33+cells in NHL patients was higher than those in healthy controls [(42±10) ％ vs. (34±11) ％, t= 0.300, P= 0.005]. The expressions of Arg-1, COX-2 and iNOS in CD11b+CD14+CD33+and CD11b+CD14+CD33-cells were 0.12±0.04 vs. 1.00±0.25 (t= 6.095, P=0.024), 3.03±0.45 vs. 1.00±0.78 (t= 7.766, P= 0.016) and 0.29±0.11 vs. 1.00±0.04 (t= 1.987, P= 0.209), respectively. In addition, the CD11b+CD14+CD33+cells inhibited T cell proliferation. The levels of MDSC in patients with different international prognostic index (IPI) score were significantly different (F= 2.536, P=0.049), but the levels of MDSC in patients with different sex, age, pathological type, stage, serum lactate dehydrogenase, physical status staging criteria and β2-microglobulin had no differences (all P < 0.05). Conclusions CD11b+ CD14+ CD33+ cells are characterized as MDSC in terms of higher level in NHL patients, expressing myeloid-specific proteins, and inhibiting T cell proliferation. The expression of MDSC is associated with IPI score, implying it might be a novel biomarker in clinical practice for NHL patients.

Burkitt lymphoma (BL) is an aggressive B-cell non-Hodgkin lymphoma which often occurs in children. The cure rate of BL is significantly increased with the wide application of short-duration and high-intensity immunochemotherapy, however, chemotherapy-related adverse reactions are still a big problem in adult patients and human immunodeficiency virus (HIV) positive patients. Meanwhile, the absence of effective immune targeting new drugs in patients with relapsed and refractory BL needs to be solved clinically. How to optimize the therapeutic regimen to reduce the chemotherapy-related adverse reactions and develop effective immune targeting new drugs is the hot spot in current research. This paper reviews the treatment progress of BL according to the 59th American Society of Hematology (ASH) Annual Meeting.

Objective To investigate the clinical features of pulmonary lymphoma and to get a better understanding of this disease. Methods Clinical data of 253 lymphoma patients in the Department of Lymphoma and Hematology in Jilin Cancer Hospital from October 2014 to March 2017 were retrospectively analyzed. The patients were divided into 30 cases of pulmonary lymphoma (lung lymphoma group) and 223 cases of non-pulmonary lymphoma (the control group). Rate assay and latex turbidimetry was used to detect lactic dehydrogenase (LDH) and β2macroglobulin (β2-MG) respectively. The expressions of programmed death 1 (PD-1), programmed death ligand 1 (PD-L1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) in peripheral blood CD4 +CD8 +T lymphocytes were detected by using flow cytometry. The count and measurement data of both groups were compared by using χ 2test and t test respectively. Results The patients in pulmonary lymphoma group showed secondary lesions. The proportion of smoking people in pulmonary lymphoma group was higher than that in the control group [43.3 % (13/30) vs. 24.2 % (54/223), χ 2＝ 4.964, P＝ 0.026]. The proportion of the patients in Ⅲ-Ⅳ stage in pulmonary lymphoma group was higher than that in the control group [93.3 % (28/30) vs. 57.0 % (127/223), χ2＝ 14.750, P < 0.001]. The proportion of the patients with higher international prognostic index (IPI) score in pulmonary lymphoma group was higher than that in the control group (χ2＝ 21.888, P < 0.001). The proportion of the patients with increased expression of β2-MG in pulmonary lymphoma group was higher compared with the control group [66.7 % (20/30) vs. 50.2 % (112/223), χ2＝6.682, P ＝0.091]. The proportion of the patients with the increased LDH was higher compared with the control group [63.3 % (19/30) vs. 41.5 % (86/223)], and the difference was statistically significant (χ2＝ 6.682, P ＝ 0.010). Diffuse large B-cell lymphoma (DLBCL) was the common pathological type in pulmonary lymphoma group (15 cases), followed by Hodgkin lymphoma (7 cases); imaging showed single mass or nodular type, multiple masses or nodular type, bilateral pulmonary infiltration, pleural effusion were 36.7 % (11/30), 30.0 % (9/30), 63.3 % (19/30) and 36.7 % (11/30), respectively. There were no statistical differences in the protein expression of immune check points such as PD-1, PD-L1 and CTLA-4 in both groups (all P ＞ 0.05). Conclusions Pulmonary DLBCL should be considered a secondary disease, but not a primary lesion. Smoking history is a risk factor for lymphoma patients with pulmonary involvement. Pulmonary lymphoma is similar to other extra-nodal lymphoma with high IPI scores, advanced stage and elevated LDH.