以维泊妥珠单抗为基础方案治疗中枢神经系统累及的难治性弥漫大B细胞淋巴瘤1例报告并文献复习  

Treatment of refractory diffuse large B-cell lymphoma involving the central nervous system with polatuzumab vedotin-based regimen:a case report and literature review

作　　者：白洁菲[1] 冯茹[1] 王婷[1] 李旭[2] 钱龙 李江涛[1] 张春丽[1] 刘辉[1] Bai Jiefei;Feng Ru;Wang Ting;Li Xu;Qian Long;Li Jiangtao;Zhang Chunli;Liu Hui(Department of Hematology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Nuclear Medicine,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院血液内科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]北京医院核医学科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中华血液学杂志》2024年第9期864-866,共3页Chinese Journal of Hematology

基　　金：国家高水平医院临床研究基金(BJ-2022-127、BJ-2023-078);北京市自然科学基金(7232137、7222158)。

摘　　要：维泊妥珠单抗(Pola)是一种靶向CD79b的新型抗体药物偶联物,临床试验显示在初诊和复发/难治的弥漫大B细胞淋巴瘤(DLBCL)中均有效。本文回顾性分析了北京医院1例脊髓受累的难治性继发性中枢神经系统淋巴瘤患者的临床特点及诊治过程,并进行相关文献复习。患者79岁,诊断为DLBCL,累及髂骨、骶骨、脊髓、神经根,IPI评分5分,MSKCC评分高风险,老年综合评估(IACA评分)2分,为不适合强化疗组。一线治疗应用无化疗方案联合放疗,患者病情进展,二线治疗应用以Pola为基础的方案,患者获得完全缓解,提示Pola可能作为累及中枢神经系统的DLBCL患者的治疗选择。Polatuzumab vedotin (Pola) is a novel antibody-drug conjugate targeting CD79b, which has been shown to be effective in treating newly diagnosed and relapsed/refractory diffuse large B cell lymphoma (DLBCL) during clinical trials. This study aims to conduct a retrospective analysis of the clinical characteristics, diagnosis, and treatment of a patient with refractory secondary central nervous system lymphoma at Beijing Hospital, alongside a review of relevant literature. This study included a 79-year-old female patient who was diagnosed with DLBCL affecting the ilium, sacrum, spinal cord, and nerve roots and had an IPI score of 5 and a high-risk score according to MSKCC. She showed a geriatric comprehensive assessment (IACA) score of 2, which was categorized under the unfit group. Her initial treatment comprised chemo-free therapy and radiotherapy, followed by progression. In the second-line treatment, a Pola-based regimen was applied, and the patient achieved a complete response, suggesting that this regimen may be a therapeutic option for patients with DLBCL involving the central nervous system.

关 键 词：弥漫大B细胞淋巴瘤 北京医院 老年综合评估 中枢神经系统 联合放疗 骶骨 二线治疗 CD7 

分 类 号：R733.1[医药卫生—肿瘤]