培美曲塞治疗原发性中枢神经系统淋巴瘤复发患者的疗效观察  

Curative effect of pemetrexed on the treatment of relapsed primary central nervous system lymphoma

作　　者：王勇[1] 王秀华[1] 赵玉娥[1] 陶荣杰[1] 朱玉方[1] 赵荣荣[2] 徐军[1] 

机构地区：[1]山东省医学科学院、山东省肿瘤防治研究院神经外科,济南250117 [2]山东省医学科学院、山东省肿瘤防治研究院血液科,济南250117

出　　处：《中华血液学杂志》2014年第1期46-49,共4页Chinese Journal of Hematology

摘　　要：目的观察采用培美曲塞治疗原发性中枢神经系统淋巴瘤（primary central nervous system lymphoma，PCNSL）复发患者的有效性及安全性。方法对收治的7例复发性PCNSL患者的临床资料进行回顾性分析。结果7例患者中有3例脑内异位复发，3例脑内原位复发，1例脑脊膜转移。复发后给予大剂量培美曲塞（900mg／m2）化疗，并补充叶酸和维生素B。每3周给药1次。经治疗后7例患者中2例达到完全缓解，3例达到部分缓解，2例疾病进展，总有效率为71．4％。不良反应主要以骨髓抑制及胃肠道反应为主。结论PCNSL患者复发后治疗困难，预后差，采用培美曲塞治疗是一项有意义的探索。Objective To explore the efficacy and safety of pemetrexed in the treatment of relapsed primary central nervous system lymphoma （PCNSL）. Methods Seven cases with relapsed PCNSL admitted in our hospital between August 2012 and August 2013 were retrospectively reviewed. Results Of the 7 relapsed cases, ectopic recurrence occurred in 3, in situ recurrence in 3 and leptomeningeal metastasis in 1. Patients with relapsed PCNSL were administered with high-dose pemetrexed （900 mg/m2） once for every 3 weeks and supplemented with folic acid and vitamin B12. Complete remission was obtained in 2 patients, partial remission in 3 patient and progressive disease in 2. The overall response rate was 71.4% （5/7）. The main adverse reactions were myelosuppression and gastrointestinal reaction. Conclusions Treatment of relapsed PCNSL is difficult, and its prognosis is very poor. Pemetrexed therapy is a meaningful trial.

关 键 词：淋巴瘤 大B细胞 弥漫性 中枢神经系统 复发 抗肿瘤联合化疗方案 培美曲塞 

分 类 号：R739.41[医药卫生—肿瘤]