程序性死亡受体1单抗及布鲁顿酪氨酸激酶抑制剂联合利妥昔单抗治疗难治原发中枢神经系统淋巴瘤1例并文献复习  

Refractory primary central nervous system lymphoma treated with programmed death-1 monoclonal antibody and Bruton tyrosine kinase inhibitor combined with rituximab:report of 1 case and review of literature

作　　者：李佳[1] 赵杨祉[1] 国巍[1] 赵红光[2] 窦乐[3] 李军娜 白鸥[1] Li Jia;Zhao Yangzhi;Guo Wei;Zhao Hongguang;Dou Le;Li Junna;Bai Ou(Department of Hematology,the First Hospital of Jilin University,Changchun 130000,China;Department of Nuclear Medicine,the First Hospital of Jilin University,Changchun 130000,China;Department of Radiology,the First Hospital of Jilin University,Changchun 130000,China)

机构地区：[1]吉林大学第一医院血液科,长春130000 [2]吉林大学第一医院核医学科,长春130000 [3]吉林大学第一医院放射线科,长春130000

出　　处：《白血病．淋巴瘤》2022年第12期734-737,共4页Journal of Leukemia & Lymphoma

摘　　要：目的探讨利妥昔单抗、程序性死亡受体1(PD-1)单抗、布鲁顿酪氨酸激酶(BTK)抑制剂联合对老年难治原发中枢神经系统淋巴瘤(PCNSL)的疗效和安全性。方法回顾性分析吉林大学第一医院2020年2月收治的1例应用利妥昔单抗、PD-1单抗、BTK抑制剂三药联合治疗的老年难治PCNSL患者的临床资料,并复习相关文献。结果患者为原发中枢神经系统弥漫大B细胞淋巴瘤(高危组),纪念斯隆凯特琳癌症中心(MSKCC)评分2分(预计总生存时间7个月)。患者1个疗程治疗后疾病进展。经利妥昔单抗、PD-1单抗联合BTK抑制剂治疗获得完全缓解。后续PD-1单抗维持治疗,随访至2021年11月17日,患者病情稳定。第2次无进展生存(PFS2)时间20个月,总生存时间21个月。患者对新药治疗耐受良好,未发生3级以上不良反应。结论新靶向联合治疗可作为老年PCNSL患者的治疗新选择,可进一步提高疗效,显著改善预后。Objective To investigate the effect and safety of rituximab,programmed death 1(PD-1)monoclonal antibody,and Bruton tyrosine kinase(BTK)inhibitor on elderly refractory primary central nervous system lymphoma(PCNSL).Methods The clinical data of an elderly patient with refractory PCNSL treated with the combination of rituximab,PD-1 monoclonal antibody and BTK inhibitor in the First Hospital of Jilin University in February 2020 were retrospectively analyzed.The relevant literature was reviewed.Results The patient had primary central nervous system diffuse large B-cell lymphoma(high-risk group),and the Memorial Sloan Kettering Cancer Center(MSKCC)score was 2(estimated overall survival time was 7 months).Disease progressed after 1 course of treatment.Complete remission was achieved after the therapy of rituximab,PD-1 monoclonal antibody combined with BTK inhibitor.PD-1 monoclonal antibody maintenance therapy was performed and patient was followed up until November 17,2021.The patient's condition was stable.The second progression-free survival(PFS)time was 20 months,and the overall survival time was 21 months.The patient well tolerated the new drug treatment,and no adverse reactions of grade 3 or above occurred.Conclusions The new targeted combination therapy can be used as a treatment option for elderly PCNSL patients,which can further improve the curative effect and significantly improve the prognosis.

关 键 词：中枢神经系统肿瘤 原发中枢神经系统淋巴瘤 难治 分子靶向治疗 程序性死亡受体1单抗 布鲁顿酪氨酸激酶 

分 类 号：R739.4[医药卫生—肿瘤]