自体造血干细胞移植序贯CD19/CD22嵌合抗原受体T细胞治疗原发难治性弥漫大B细胞淋巴瘤1例并文献复习  

Autologous hematopoietic stem cell transplantation followed by sequential CD19/CD22 chimeric antigen receptor T cells for the treatment of primary refractory diffuse large B-cell lymphoma:a case report and literature review

作　　者：张嘉雯 王椋[2] ZHANG Jiawen;WANG Liang(School of Clinical Medicine,Shandong Second Medical University,Weifang,Shandong 261000,China;Department of Hematology,Shengli Oilfield Central Hospital,Dongying,Shandong 257000,China)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261000 [2]胜利油田中心医院血液内科,山东东营257000

出　　处：《安徽医药》2025年第4期793-797,共5页Anhui Medical and Pharmaceutical Journal

基　　金：山东省医药卫生科技发展计划项目(202220304045414)。

摘　　要：目的为原发难治性弥漫大B细胞淋巴瘤治疗提供可能的思路。方法回顾性分析胜利油田中心医院于2022年9月7日收治的1例原发难治性弥漫大B细胞淋巴瘤的临床资料并复习相关文献。结果该病人先后给予利妥昔单抗联合吡柔比星、环磷酰胺、长春地辛及泼尼松(R-CHOP)方案化疗1疗程、利妥昔单抗联合多柔比星脂质体、环磷酰胺、长春地辛及泼尼松(R-CDOP)方案化疗2个疗程后病情进展,后给予奥布替尼联合利妥昔单抗联合依托泊苷、异环磷酰胺及卡铂(奥布替尼+R-ICE)方案治疗后腹腔仍可见大包块,放疗降低肿瘤负荷后行自体造血干细胞移植序贯CD19/CD22嵌合抗原受体T细胞治疗。过程中出现2级细胞因子释放综合征经对症处理后症状缓解。后行PET-CT评估疗效为完全代谢缓解。结论自体造血干细胞移植序贯CD19/CD22嵌合抗原受体T细胞是治疗原发难治性弥漫大B细胞淋巴瘤的有效方法。Objective To provide reference for the treatment of primary refractory diffuse large B-cell lymphoma.Methods The clinical data of a case of primary refractory diffuse large B-cell lymphoma admitted to Shengli Oilfield Central Hospital on September 7,2022 were retrospectively analyzed and related literature was reviewed.Results The patient's condition worsened after 1 course of chemotherapy with rituximab,pirarubicin,cyclophosphamide,vincristine and prednisone(R-CHOP)and 2 courses of chemotherapy with rituximab,doxorubicin liposomal,cyclophosphamide,vincristine and prednisone(R-CDOP).After treatment with aubutinib,rituximab,etoposide,ifosfamide,carboplatin(aubutinib plus R-ICE),large masses were still visible in the abdominal cavity.Autologous hematopoietic stem cell transplantation followed by sequential CD19/CD22 chimeric antigen receptor T cell therapy was performed after radiotherapy to reduce tumor load.Grade 2 cytokine release syndrome appeared during the therapeutic process,and the symptoms were relieved after symptomatic treatment.PET-CT evaluation indicated complete metabolic remission.Conclusion Autologous hematopoietic stem cell transplantation followed by sequential CD19/CD22 chimeric antigen receptor T cells is an effective therapy for primary refractory diffuse large B-cell lymphoma.

关 键 词：淋巴瘤 大B细胞 弥漫性 序贯治疗 嵌合抗原受体T细胞 自体造血干细胞移植 放疗 

分 类 号：R733.1[医药卫生—肿瘤]