弥漫性大B细胞淋巴瘤继发中枢神经系统侵犯的诊疗进展  

Progress in the diagnosis and treatment of secondary central nervous system diffuse large B-cell lymphoma

作　　者：何天珩 邓丽娟 宋玉琴 朱军 Tianheng He;Lijuan Deng;Yuqin Song;Jun Zhu(Lymphoma Unit,Peking University International Hospital,Beijing 102206,China;Department of Lymphoma,Beijing Cancer Hospital,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Beijing 100142,China)

机构地区：[1]北京大学国际医院淋巴瘤科,北京市102206 [2]北京肿瘤医院淋巴肿瘤内科,恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中国肿瘤临床》2021年第15期797-801,共5页Chinese Journal of Clinical Oncology

摘　　要：弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)继发中枢神经系统(central nervous system,CNS)侵犯是一种严重的临床并发症,治疗方法有限,预后普遍较差。随着利妥昔单抗的广泛应用,其发生率呈降低趋势,但是脑实质受累越发多见,病理活检在诊断中则越发重要。在高危因素鉴定方面需要结合临床与分子生物学因素综合评估。以大剂量甲氨蝶呤为主的全身化疗作为主流的预防策略,其作用尚存争议。伊布替尼等新药、新疗法的治疗价值得到进一步探索。本文旨在对近年来DLBCL继发CNS侵犯的诊疗进展予以综述。Secondary central nervous system diffuse large B-cell lymphoma(DLBCL)is a serious clinical complication with limited treatment options and a generally poor prognosis.With the widespread use of rituximab,its incidence has tended to decrease,and brain parenchymal involvement is becoming more common.The importance of pathological biopsy in diagnosis is increasing.The identification of high-risk factors requires a comprehensive evaluation of clinical and molecular biological factors.Although systemic chemotherapy with high-dose methotrexate is the mainstay of prophylaxis,its role in treatment is controversial.The therapeutic value of new drugs and therapies,such as ibrutinib,needs to be explored further.This review summarizes the progress in the diagnosis and treatment of secondary central nervous system DLBCL in recent years.

关 键 词：继发性 中枢神经系统淋巴瘤 弥漫性大B细胞淋巴瘤 化学免疫治疗 

分 类 号：R733.1[医药卫生—肿瘤]