Blastic Plasmacytoid Dendritic Cell Neoplasm: Progress in Cell Origin, Molecular Biology, Diagnostic Criteria and Therapeutic Approaches

Curr Med Sci. 2021 Jun;41(3):405-419. doi: 10.1007/s11596-021-2393-3. Epub 2021 Jul 3.

Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy characterized by recurrent skin nodules, an aggressive clinical course with rapid involvement of hematological organs, and a poor prognosis with poor overall survival. BPDCN is derived from plasmacytoid dendritic cells (pDCs) and its pathogenesis is unclear. The tumor cells show aberrant expression of CD4, CD56, interleukin-3 receptor alpha chain (CD123), blood dendritic cell antigen 2 (BDCA 2/CD303), blood dendritic cell antigen 4 (BDCA4) and transcription factor (E protein) E2-2 (TCF4). The best treatment drugs are based on experience by adopting those used for either leukemia or lymphoma. Relapse with drug resistance generally occurs quickly. Stem cell transplantation after the first complete remission is recommended and tagraxofusp is the first targeted therapy. In this review, we summarize the differentiation of BPDCN from its cell origin, its connection with normal pDCs, clinical characteristics, genetic mutations and advances in treatment of BPDCN. This review provides insights into the mechanisms of and new therapeutic approaches for BPDCN.

Keywords: blastic plasmacytoid dendritic cell neoplasm; genetic mutations; immunophenotype; plasmacytoid dendritic cell; therapeutics.

Publication types

  • Review

MeSH terms

  • Acute Disease / epidemiology
  • Antigens, Surface / genetics
  • CD4 Antigens / genetics
  • CD56 Antigen / genetics
  • Cell Differentiation / genetics
  • Dendritic Cells / metabolism
  • Dendritic Cells / pathology*
  • Disease Progression
  • Hematologic Neoplasms / genetics*
  • Hematologic Neoplasms / pathology
  • Humans
  • Interleukin-3 Receptor alpha Subunit / genetics
  • Lectins, C-Type / genetics
  • Membrane Glycoproteins / genetics
  • Receptors, Immunologic / genetics
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / genetics*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy
  • Transcription Factor 4 / genetics

Substances

  • Antigens, Surface
  • CD4 Antigens
  • CD56 Antigen
  • CLEC4C protein, human
  • IL3RA protein, human
  • Interleukin-3 Receptor alpha Subunit
  • Lectins, C-Type
  • Membrane Glycoproteins
  • Receptors, Immunologic
  • TCF4 protein, human
  • Transcription Factor 4
  • blood dendritic cell antigen 4, human