利妥昔单抗鞘注联合静脉化疗治疗脾边缘区淋巴瘤中枢神经系统复发一例并文献复习  

Rituximab intrathecal injection combined with intravenous chemotherapy in the successful treatment of splenic marginal zone lymphoma with the central nervous system relapse： a case report and literatures review

作　　者：陈晓晨[1] 金正明[1] 韩悦[1] 郭凌川[1] 吴德沛[1] 

机构地区：[1]苏州大学附属第一医院江苏省血液研究所卫生部血栓与止血重点实验室,215006

出　　处：《白血病．淋巴瘤》2013年第7期419-422,共4页Journal of Leukemia & Lymphoma

基　　金：国家高技术研究发展计划（863计划）（2011AA020105）;江苏高校优势学科建设工程项目;江苏省临床医学中心项目（ZX201102）;江苏省科技厅生命健康科技专项资金（BL2012005）

摘　　要：目的 分析脾边缘区淋巴瘤中枢神经系统复发患者的临床、影像学、病理学特征,评估利妥昔单抗鞘注联合静脉化疗的安全性及疗效.方法 回顾性分析苏州大学附属第一医院血液科收治的1例脾边缘区淋巴瘤中枢神经系统复发患者的临床、影像学、病理学及治疗资料,并复习相关文献.结果 根据骨髓细胞形态学、免疫学、细胞遗传学和分子遗传学（MICM）分型、脾脏病理、PET-CT及实验室检查（乳酸脱氢酶）等,患者明确诊断为脾边缘区淋巴瘤Ⅳ期B组,国际预后指数（IPI）和年龄调整的国际预后指数（aaIPI）均为中高危组.经过一线治疗,患者达到完全缓解.但随后出现中枢神经系统复发,予利妥昔单抗鞘注联合静脉化疗治疗后,中枢病灶消失.结论 脾边缘区淋巴瘤属于低度恶性淋巴瘤,合并中枢神经系统复发十分罕见.利妥昔单抗鞘注联合静脉化疗对本例患者是安全的,且获得很好的临床疗效.Objective To explore the clinical characteristics,pathological features,therapy and prognosis of a case of splenic marginal zone lymphoma （SMZL） with central recurrence,evaluation the safety and efficacy of rituximab intrathecal injection combined with intravenous chemotherapy.Methods Retrospectively analyze the case of SMZL with the central recurrence,and review the relevant literatures.Results According to the tests of MICM of bone marrow,spleen pathology,PET-CT and laboratory examination （LDH）,patient was diagnosed as SMZL,IV group B,IPI and aaIPI was high risk group.After first-line therapy,the patient achieved complete remission.But then the central nervous system relapsed.The patients was treated with rituximab intrathecal injection combined with intravenous chemotherapy,the central focus disappeared.Conclusion SMZL belongs to low-grade lymphoma,which combined with central nervous system relapse is very rare.Rituximab intrathecal injection combined with intravenous chemotherapy in the treatment of the patients is safe to use,and have good clinical efficacy.

关 键 词：利妥昔单抗 注射 脊髓 脾边缘区淋巴瘤 中枢神经系统 复发 

分 类 号：R733.2[医药卫生—肿瘤]