含泽布替尼联合方案治疗老年中枢神经系统淋巴瘤患者3例并文献复习  

Zanubrutinib combined regimens for treatment of elderly patients with central nervous system lymphoma:report of 3 cases and review of literature

作　　者：余晓[1] 方宝枝[1] 袁慕知[1] 周一飞[1] 沈秋丹[1] 吕明恩[1] Yu Xiao;Fang Baozhi;Yuan Muzhi;Zhou Yifei;Shen Qiudan;Lyu Ming'en(Department of Hematology,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215002,China)

机构地区：[1]南京医科大学附属苏州医院血液科,苏州215002

出　　处：《白血病．淋巴瘤》2022年第9期539-543,共5页Journal of Leukemia & Lymphoma

基　　金：国家自然科学基金青年基金(81700111)。

摘　　要：目的探讨含泽布替尼联合方案治疗老年中枢神经系统淋巴瘤(CNSL)患者的效果和安全性。方法回顾性分析2020年7月至2022年3月南京医科大学附属苏州医院接受泽布替尼联合方案治疗的3例老年CNSL患者临床资料,其中2例为原发中枢神经系统淋巴瘤(PCNSL),1例为继发中枢神经系统淋巴瘤(SCNSL),并进行文献复习。结果2例PCNSL均接受泽布替尼联合利妥昔单抗、来那度胺(Z-R2)方案治疗,其中1例治疗6个疗程后达完全缓解(CR),另1例治疗1个疗程后达部分缓解(PR)。1例SCNSL为原发硬膜外弥漫大B细胞淋巴瘤(DLBCL)CR后中枢神经系统复发,接受Z-R2方案治疗2个疗程后达PR,再接受泽布替尼联合利妥昔单抗、大剂量甲氨蝶呤(Z-R-HD-MTX)方案治疗4个疗程后达到CR。截至2022年4月2例患者仍处于CR状态,最长无病生存时间已达15个月。治疗过程中无严重不良反应发生。结论泽布替尼联合方案治疗3例老年CNSL患者取得了较好的疗效,且耐受性良好,给不能耐受强化疗或无法行自体造血干细胞移植的患者提供了新的治疗选择。Objective To investigate the efficacy and safety of zanubrutinib combined regimens for treatment of elderly patients with central nervous system lymphoma(CNSL).Methods The clinical data of 3 elderly patients with CNSL who received zanubrutinib combined regimens from July 2020 to March 2022 in the Affiliated Suzhou Hospital of Nanjing Medical University were retrospectively analyzed.Two of them were primary central nervous system lymphoma(PCNSL)and one was secondary central nervous system lymphoma(SCNSL).Relevant literature was reviewed at the same time.Results The two patients with PCNSL were treated with zanubrutinib in combination with rituximab and lenalidomide(Z-R2)regimen.One of them achieved complete remission(CR)after 6 cycles,and the other patient achieved partial remission(PR)after 1 cycle of Z-R2 regimen.The patient with SCNSL was diagnosed with diffuse large B-cell lymphoma(DLBCL)previously and suffered from central nervous system relapse after achieving CR.The patient achieved PR after 2 cycles of Z-R2 regimen,and then achieved CR followed by 4 cycles of zanubrutinib in combination with rituximab and high-dose methotrexate(Z-R-HD-MTX)regimen.Two of the three patients were still in CR until April 2022,and the longest disease-free survival time was 15 months.There were no severe adverse reactions during the treatment.Conclusions Zanubrutinib combined regimens for 3 elderly patients with CNSL have shown promising effect and well tolerance,which may be considered as novel treatment for CNSL patients who are unable to tolerate severe chemotherapies or autologous hematopoietic stem cell transplantations.

关 键 词：淋巴瘤 中枢神经系统肿瘤 抗肿瘤联合化疗方案 泽布替尼 老年人 

分 类 号：R739.4[医药卫生—肿瘤]