靶向药物联合治疗复发难治套细胞淋巴瘤的方案探讨  

Clinical strategy of combined target drugs in treatment of relapsed/refractory mantle cell lymphoma

作　　者：侯理[1] 杨云帆 钟旭姝[1] 牛挺[1] 刘霆[1] HOU Li;YANG Yunfan;ZHONG Xushu;NIU Ting;LIU Ting(Department of Hematology and Laboratory,Western China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院血液内科血液病研究室

出　　处：《中国输血杂志》2020年第1期38-41,共4页Chinese Journal of Blood Transfusion

基　　金：中央高校基本科研业务费专项(2017SCU11052)

摘　　要：目的探讨套细胞淋巴瘤(MCL)复发难治患者不宜化疗时的有效治疗方案。方法针对1名复发难治MCL老年患者在服用伊布替尼治疗过程中,由于合并感染及全身情况不佳而无法耐受治(化)疗的情况,采用靶向药物bcl-2抑制剂(100 mg/d)联合BTK抑制剂(伊布替尼560 mg/d)予以治疗,治疗结束后评估该治疗方案的有效性。结果患者接受BTK抑制剂伊布替尼联合靶向药物bcl-2抑制剂治疗后,病情得到控制:脱离输血依赖,肿瘤缩小,血象恢复、临床症状及影像学达到部分缓解。结论靶向药物bcl-2抑制剂联合BTK抑制剂治疗方案对于无法接受化疗的复发难治MCL患者,是1种安全有效,耐受良好的治疗选择。Objective To generate efficacious therapeutic plans for a patient suffered from relapsed/refractory mantle cell lymphoma(MCL),who are not legible for chemotherapy. Methods One old female with relapsed/refractory MCL had the disease progressed during Ibrutinib treatment. Because of poor performance condition and complication of infection, she was not suitable for further chemotherapy. We improved the treatment by adopting the combined inhibitor of bcl-2(Ventoclax 100 mg/d) and BTK(Ibrutinib 560 mg/d), inspired by the previous studies. The clinical data of the patient was analyzed to provide valuable references in the treatment of these critically ill patients with relapsed/refractory MCL. Results After the combined therapy of two new targeted drugs, disease was controlled and tumor shrank immediately, with the rapid recovery of hematopoiesis;the patient got rid of transfusion and achieved partial remission. Until finally death from a sever pneumonia, her peripheral blood count was almost normal. Conclusion Combination of new targeted drugs in treatment of relapsed/refractory MCL is an effective and well tolerated option in critically ill patients.

关 键 词：套细胞淋巴瘤 复发难治 靶向药物 肿瘤抑制剂 化学疗法 

分 类 号：R456[医药卫生—治疗学] R733.4[医药卫生—临床医学]