原发纵隔大B细胞淋巴瘤的治疗进展  

Progress in treatment of primary mediastinal large B-cell lymphoma

作　　者：陈吕雯 李建勇[1] 范磊[1] Chen Lyuwen;Li Jianyong;Fan Lei(Department of Hematology,the First Affiliated Hospital with Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院血液科,南京210029

出　　处：《中华血液学杂志》2024年第1期98-102,共5页Chinese Journal of Hematology

基　　金：希思科临床肿瘤学研究基金(Y-Roche2019/2-0090);伊犁州临床医学研究院研究基金项目(yl2021ms04);临床能力提升工程(JSPH-MB-2021-9)。

摘　　要：原发纵隔大B细胞淋巴瘤(PMBCL)是一种起源于胸腺的侵袭性B细胞淋巴瘤。具有不同于非特指型弥漫大B细胞淋巴瘤的临床和生物学特征,PMBCL好发于年轻女性,通常表现为前纵隔巨大肿块,大多数患者就诊时处于Ⅰ~Ⅱ期,目前尚无标准的PMBCL预后评分系统。PMBCL治疗多采用免疫化疗,但最佳一线治疗方案尚无定论,并且放疗的地位存在争议,PET-CT指导治疗的价值有待进一步证实。复发/难治PMBCL预后较差,PD-1抑制剂、维布妥昔单抗和CAR-T细胞等新型疗法有助于改善此类患者生存。Primary mediastinal large B-cell lymphoma(PMBCL)is an aggressive B-cell lymphoma originating from the thymus,which has different clinical and biological characteristics from diffuse large B-cell lymphoma,NOS.PMBCL tends to occur in young women,usually presenting as a large anterior mediastinal mass.Most patients are in stageⅠ-Ⅱat the time of presentation.There is no standard prognostic scoring system for PMBCL.Immunochemotherapy is commonly used in the treatment of PMBCL,but the optimal first-line treatment has not been determined,and the status of radiotherapy is controversial.The value of PET-CT guided therapy needs to be further verified.Relapsed/refractory PMBCL has a poor prognosis,while novel therapies such as PD-1 inhibitors,brentuximab vedotin,and CAR-T can help improve survival in these patients.

关 键 词：弥漫大B细胞淋巴瘤 前纵隔 免疫化疗 原发纵隔大B细胞淋巴瘤 一线治疗方案 年轻女性 复发/难治 指导治疗 

分 类 号：R734.5[医药卫生—肿瘤]