弥漫大B细胞淋巴瘤合并乙型肝炎病毒感染的研究现状  

Research status on diffuse large B cell lymphoma complicated with hepatitis B virus infection

作　　者：沈汉影 朱锋 Shen Hanying;Zhu Feng(Department of Hematology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院,徐州221002

出　　处：《国际输血及血液学杂志》2022年第5期375-382,共8页International Journal of Blood Transfusion and Hematology

基　　金：国家自然科学基金(82170187)。

摘　　要：弥漫大B细胞淋巴瘤(DLBCL)合并乙型肝炎病毒(HBV)感染的患者逐年增多。该病的发病机制尚未完全阐明,治疗方案尚不统一。针对DLBCL合并HBV感染患者DLBCL的首选治疗方案为R-CHOP(利妥昔单抗+环磷酰胺+多柔比星+长春新碱+泼尼松)方案,但可能引起不同程度的HBV再激活,严重者甚至可导致肝功能衰竭或者患者死亡。嵌合抗原受体T细胞(CAR-T)免疫疗法作为一种新疗法,治疗复发/难治性DLBCL已取得显著疗效,但仍存在争议。对于DLBCL合并HBV感染患者,化疗前应实施预防性抗HBV治疗,从而避免HBV再激活,使患者可完成多个疗程化疗,改善患者预后。为了进一步探索DLBCL与HBV之间的关系,笔者拟就DLBCL合并HBV感染患者的临床表现、发病机制、治疗和预后等方面的研究现状进行阐述。Diffuse large B cell lymphoma(DLBCL)complicated with hepatitis B virus(HBV)infection has been reported in more and more patients.Pathogenesis of DLBCL complicated with HBV infection is not completely clear and the treatment is not uniform.R-CHOP(rituximab+cyclophosphamide+doxorubicin+vincristine+prednisone)regimen,the preferred regimen for DLBCL,may cause different levels of HBV reactivation and even lead to liver failure or death in severe cases.Chimeric antigen receptor T cell(CAR-T)immunotherapy as a new therapy has achieved significant outcomes in recurrent/refractory DLBCL,but there is still controversial.For DLBCL patients complicated with HBV infection,prophylactic anti-HBV therapy should be administered before chemotherapy to avoid HBV reactivation,and complete multiple courses of chemotherapy and improve prognosis of patients.In order to further understand the relationship between DLBCL and HBV,this article will elaborate on the research status of clinical manifestations,pathogenesis,treatment and prognosis of DLBCL complicated with HBV infection.

关 键 词：淋巴瘤 大B细胞 弥漫性 乙型肝炎病毒 免疫疗法 过继 乙型肝炎病毒再激活 嵌合抗原受体T细胞免疫疗法 

分 类 号：R733.1[医药卫生—肿瘤] R512.62[医药卫生—临床医学]