Real-world outcomes of plasmablastic lymphoma: Treatment approaches and survival outcomes in the PLASMABLAT-001 cohort.

BACKGROUND

Plasmablastic lymphoma (PBL) is a rare and aggressive malignancy frequently associated with human immunodeficiency virus (HIV) infection and lacking standardized treatment strategies. We developed the PLASMABLAT-001 retrospective cohort to describe treatment patterns and outcomes in PBL.

METHODS

We retrospectively analyzed 86 patients diagnosed between 2008 and 2023 across six Latin American centers. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method, and Cox regression models identified prognostic factors.

RESULTS

The cohort was predominantly male (87%), with a median age of 41 years; 72% were HIV-positive. Advanced-stage disease and extranodal involvement (89%) were common. EPOCH-based regimens were used in 75% of patients. Complete response rates were 51% in first-line and 30% in second-line therapy. After a median follow-up of 26.1 months (95% CI, 17.9-42.5), the 2-year OS was 60% (95% CI, 48-72%), while median OS was not reached. Median PFS was 9 months (95% CI, 6-12). HIV-negative patients had improved OS and PFS. In multivariable analysis, HIV negativity, ECOG performance status 0-2, and absence of MYC rearrangements were associated with improved OS.

CONCLUSION

PBL remains a highly aggressive disease with suboptimal outcomes in Latin America. HIV status, ECOG performance status, and MYC rearrangements are important prognostic factors. Prospective studies are needed to optimize treatment strategies.