CD20-negative diffuse large B-cell lymphomas: biology and emerging therapeutic options

Expert Rev Hematol. 2015 Jun;8(3):343-54. doi: 10.1586/17474086.2015.1007862. Epub 2015 Feb 1.


CD20-negative diffuse large B-cell lymphoma (DLBCL) is a rare and heterogeneous group of lymphoproliferative disorders. Known variants of CD20-negative DLBCL include plasmablastic lymphoma, primary effusion lymphoma, large B-cell lymphoma arising in human herpesvirus 8-associated multicentric Castleman disease and anaplastic lymphoma kinase-positive DLBCL. Given the lack of CD20 expression, atypical cellular morphology and aggressive clinical behavior characterized by chemotherapy resistance and inferior survival rates, CD20-negative DLBCL represents a challenge from the diagnostic and therapeutic perspectives. The goals of the present review are to summarize the current knowledge on the biology of the distinct variants of CD20-negative DLBCL, provide future therapeutic directions based on the limited preclinical and clinical data available, and increase awareness concerning these rare malignancies among pathologists and clinicians.

Keywords: ALK-positive DLBCL; CD20-negative; multicentric Castleman disease; plasmablastic lymphoma; primary effusion lymphoma.

Publication types

  • Review

MeSH terms

  • Animals
  • Antigens, CD20 / analysis*
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / pathology*
  • B-Lymphocytes / virology
  • Castleman Disease / diagnosis
  • Castleman Disease / pathology
  • Castleman Disease / therapy
  • Castleman Disease / virology
  • Herpesviridae Infections / complications
  • Herpesvirus 8, Human / isolation & purification
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Lymphoma, Large B-Cell, Diffuse / virology


  • Antigens, CD20
  • Antineoplastic Agents

Supplementary concepts

  • Multi-centric Castleman's Disease