布鲁顿酪氨酸激酶抑制剂治疗老年/体弱原发性中枢神经系统淋巴瘤患者的临床疗效和安全性分析  

Efficacy and safety of Bruton’s tyrosine kinase inhibitors for the elderly or infirm patients with primary central nervous system lymphoma

作　　者：徐佳欢 张倩[2] 冯佳[2] 孙丽华[2] 钟凤鸾[2] 张文丽[2] 许蕾[2] 徐海婵[2] 温娟娟[2] 覃宝珍[2] 蒋官忆 李晋萌 陈思亮 吴泽华 戴婧 张红宇 XU Jia-huan;ZHANG Qian;FENG Jia;SUN Li-hua;ZHONG Feng-luan;ZHANG Wen-li;XU Lei;XU Hai-chan;WEN Juan-juan;QIN Bao-zhen;JIANG Guan-yi;LI Jin-meng;CHEN Si-liang;WU Ze-hua;DAI Jing;ZHANG Hong-yu(College of Clinical,Peking University Shenzhen Hospital/Fifth Clinical Medical College,Anhui Medical University,Hefei 230032;Department of Hematology,Shenzhen Hospital of Peking University,Shenzhen Guangdong 518000)

机构地区：[1]安徽医科大学北大深圳医院临床学院/安徽医科大学第五临床医学院,合肥230032 [2]北京大学深圳医院血液内科,广东深圳518000

出　　处：《中南药学》2024年第12期3280-3285,共6页Central South Pharmacy

基　　金：广东省自然科学基金项目(编号:2021A151012185);深圳市科创委基础研究专项(编号:JCYJ20210324105802007)。

摘　　要：目的 探讨布鲁顿酪氨酸激酶(BTK)抑制剂治疗老年/体弱原发性中枢神经系统淋巴瘤患者的临床疗效和安全性,并随访生存情况。方法 回顾性收集2018年3月至2023年3月北京大学深圳医院收治的老年/体弱原发性中枢神经系统淋巴瘤患者15例,收集患者的临床资料。所有患者接受基于BTK抑制剂的诱导或维持治疗,观察其无进展生存期(PFS)、总生存期(OS)和不良反应。结果 15例患者中位维持治疗时间为13(IQR 7~16)个月,6个月、12个月的PFS率分别为85.6%、66.7%,中位PFS为13个月。中位OS在随访期内未达到。有5例原发性中枢神经系统淋巴瘤患者行BTK抑制剂联合治疗,有10例原发性中枢神经系统淋巴瘤患者接受了BTK抑制剂单药治疗,两组患者PFS、OS差异均无统计学意义。在本研究中,观察到的不良反应有白细胞减少、血红蛋白减少、肺部感染、复杂性尿路感染等。结论 BTK抑制剂单药或联合治疗在老年/体弱原发性中枢神经系统淋巴瘤患者中具有良好的临床疗效,且不良反应可耐受,值得临床进一步推广应用。Objective To evaluate the clinical efficacy and safety of Bruton’s tyrosine kinase (BTK) inhibitors for elderly or infirm patients with primary central nervous system lymphoma (PCNSL),and to assess the post-treatment survival outcomes.Methods Date of 15 elderly and infirm PCNSL patients treated at Shenzhen Hospital of Peking University between March 2018 and March 2023 were retrospectively analyzed.The treatment regimen included induction or maintenance therapy with BTK inhibitors.The key endpoints included progression-free survival (PFS),overall survival (OS),and adverse events.Results The median duration of maintenance therapy was 13 months (interquartile range,7 to 16 months).The PFS rates at 6 and 12 months were 85.6% and 66.7%,respectively,with a median PFS of 13 months.We failed to reach the median OS within the follow-up period.Among the cohort,five patients received combination therapy with BTK inhibitors,and the other ten patients received therapy with single BTK inhibitor,without obvious difference in the PFS and OS between the two groups.The observed adverse events included leukopenia,anemia,pulmonary infections,and complex urinary tract infections.Conclusion BTK inhibitor monotherapy and combination therapy demonstrate good clinical efficacy and manageable safety profiles in the elderly and infirm patients with PCNSL,which facilitates further clinical application of BTK inhibitors in the elderly.

关 键 词：布鲁顿酪氨酸激酶抑制剂 原发性中枢神经系统淋巴瘤 临床疗效 安全性 

分 类 号：R96[医药卫生—药理学] R739.4[医药卫生—药学]