Prognosis and treatment of plasmablastic lymphoma in the United States: a multicenter retrospective study

Plasmablastic lymphoma (PBL) is a rare, aggressive AIDS-related lymphoma observed in patients with immunosuppressed states as well as in immunocompetent individuals. We sought to determine survival outcomes, prognostic factors, and optimal treatment regimens in a large, contemporary cohort of patients with PBL in the United States. We performed a multicenter, retrospective cohort study, including 344 patients diagnosed with PBL between 2005 and 2022. Patients were stratified into cohorts according to underlying immune status. Survival outcomes were calculated using Kaplan-Meier statistics, with cohort-specific survival outcomes adjusted using propensity score-based weighting. Factors associated with outcomes were assessed via multivariable models using multiple imputation. The median age at diagnosis was 53 years, most patients were male (n = 270), and many had HIV (n = 164). The median OS was 5.0 years, with a median PFS of 1.4 years. Patients living with HIV had the best outcomes, whereas patients with prior organ transplantation had the worst outcomes. Use of higher intensity chemotherapy regimens and use of a proteasome inhibitor in the frontline setting did not show survival benefit. While there was no clear optimal treatment approach in the frontline setting, the median OS of 5.0 years is dramatically improved compared with historical controls.

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Publication Details

Journal
Blood Cancer Journal
Published
2026-03-23
DOI
https://doi.org/10.1038/s41408-026-01457-3
Primary Topic
Viral-associated cancers and disorders
Type
article
Field-Weighted Citation Impact
0.00
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article

Prognosis and treatment of plasmablastic lymphoma in the United States: a multicenter retrospective study

Charles Milrod, Nyein Nyein Thaw Dar, Vineel Bhatlapenumarthi, Brian Lee Egleston et al.
Blood Cancer Journal
Viral-associated cancers and disorders
article

Prognosis and treatment of plasmablastic lymphoma in the United States: a multicenter retrospective study

Charles Milrod, Nyein Nyein Thaw Dar, Vineel Bhatlapenumarthi, Brian Lee Egleston, Stefan Klaus Barta, Emily Hamburger, Romil Patel, Sahaj Desai, Gabriella Magarelli, JJ Castillo, Gordon Smilnak, R. Steiner, Neha Mehta-Shah, Imran Nizamuddin, Joanna Meehan Rhodes, Gaston Jean-Louis, Alexandra E. Rojek, Seda S. Tolu, Anthony Ariotti, William Han Bae, Jennifer E. Amengual, Alexander R. Vartanov, Christopher Dittus, Timothy J. Voorhees, Emily C. Ayers, Zachary AK Frosch, Matthew Hamby, P Rubinstein, Veronica Carvajal, John Sharp, E A Chong, Ariela Noy, Andres Ramirez-Gamero, Niloufer Khan, Tatyana Feldman, Adam J. Olszewski, Carlos Galvez, Gita Suneja, Sairah Ahmed, Jose Sandoval-Sus, Mehdi Hamadani, Peter A. Riedell, Vinod Solipuram, Meredith Pellon, Robert Baiocchi, Alexey Danilov, David M. Aboulafia
article en

Abstract

Plasmablastic lymphoma (PBL) is a rare, aggressive AIDS-related lymphoma observed in patients with immunosuppressed states as well as in immunocompetent individuals. We sought to determine survival outcomes, prognostic factors, and optimal treatment regimens in a large, contemporary cohort of patients with PBL in the United States. We performed a multicenter, retrospective cohort study, including 344 patients diagnosed with PBL between 2005 and 2022. Patients were stratified into cohorts according to underlying immune status. Survival outcomes were calculated using Kaplan-Meier statistics, with cohort-specific survival outcomes adjusted using propensity score-based weighting. Factors associated with outcomes were assessed via multivariable models using multiple imputation. The median age at diagnosis was 53 years, most patients were male (n = 270), and many had HIV (n = 164). The median OS was 5.0 years, with a median PFS of 1.4 years. Patients living with HIV had the best outcomes, whereas patients with prior organ transplantation had the worst outcomes. Use of higher intensity chemotherapy regimens and use of a proteasome inhibitor in the frontline setting did not show survival benefit. While there was no clear optimal treatment approach in the frontline setting, the median OS of 5.0 years is dramatically improved compared with historical controls.

Blood Cancer JournalVol. 16(1)
Rutgers, The State University of New Jersey (US), University of North Carolina at Chapel Hill (US), Fox Chase Cancer Center (US), City Of Hope National Medical Center (US), Virginia Mason Medical Center (US), Hackensack University Medical Center (US), Memorial Sloan Kettering Cancer Center (US), The University of Texas MD Anderson Cancer Center (US), Medical College of Wisconsin (US), Washington University in St. Louis (US), University of Utah (US), Brown University (US), Columbia University Irving Medical Center (US), The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US), John H. Stroger, Jr. Hospital of Cook County (US), Huntsman Cancer Institute (US), Moffitt Cancer Center (US), University of Illinois Chicago (US), St. Matthew's University (KY), University of Chicago (US), Memorial Healthcare System (US), Dana-Farber Cancer Institute (US), Rutgers Cancer Institute (US), UNC Lineberger Comprehensive Cancer Center, University of Virginia (US), The Ohio State University (US), University of Pennsylvania (US)
Good health and well-being
Openalex Percentile: Top 11%
Viral-associated cancers and disorders
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