维布妥昔单抗治疗滤泡性淋巴瘤转化的经典霍奇金淋巴瘤1例并文献复习  

One case of classical Hodgkin lymphoma transformed from follicular lymphoma treated with brentuximab vedotin and literature review

作　　者：雷钰 王政江 刘甜梦 盛志新[2] LEI Yu;WANG Zhengjiang;LIU Tianmeng;SHENG Zhixin(School of Clinical Medicine,Shandong Second Medical University,Weifang,Shandong,261000,China;Department of Hematology,Weifang People's Hospital)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261000 [2]潍坊市人民医院血液内科

出　　处：《临床血液学杂志》2025年第3期243-246,251,共5页Journal of Clinical Hematology

摘　　要：国内关于滤泡性淋巴瘤(FL)转化为经典霍奇金淋巴瘤的报道较罕见,为了提高对该类疾病的认识,为其诊疗提供临床经验,文章报道1例FL转化为经典霍奇金淋巴瘤的罕见病例,探讨维布妥昔单抗治疗FL转化的经典霍奇金淋巴瘤的效果,并进行相关文献复习。患者为70岁女性,2022年9月确诊FL 1级(Ⅳ期B组,FL国际预后指数-1评分4分,高危组),予以R-CHOP方案(利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松龙)化疗8个周期,4个周期复查,增强CT评估达部分缓解(PR),8个周期复查,增强CT评估达PR,随后予以利妥昔单抗维持治疗1次后疾病进展。2023年7月经淋巴结组织活检明确诊断为经典霍奇金淋巴瘤,考虑FL转化为经典霍奇金淋巴瘤。予以ABVD方案(阿霉素、博来霉素、长春花碱、达卡巴嗪)化疗2个疗程后疾病评估达疾病稳定,考虑疗效不佳,更换方案为BV+AVD(维布妥昔单抗+多柔比星+长春新碱+达卡巴嗪),2个疗程后复查CT提示多处淋巴结明显缩小,后患者发生严重肺部感染,抗感染治疗无效后死亡。FL转化的经典霍奇金淋巴瘤对维布妥昔单抗敏感,日后对于此类患者也可尝试采用维布妥昔单抗联合PD-1单抗或弱化疗方案。Reports on the transformation of follicular lymphoma(FL)into classical Hodgkin lymphoma(cHL)in China are rare.To enhance the understanding of this type of disease and provide clinical experience for its diagnosis and treatment,this paper reports a rare case of FL transforming into cHL,explores the efficacy of brentuximab vedotin(BV)in the treatment of cHL transformed from FL,and conducts a review of relevant literature.The patient was a 70-year-old woman,confirmed as FL grades 1in September 2022(GroupⅣB,FL international prognostic index-1score 4points,high-risk group).She received 8cycles of chemotherapy with the R-CHOP regimen.After 4cycles,enhanced CT evaluation showed a partial response(PR).After 8cycles,enhanced CT evaluation still showed a partial response(PR),and then disease progression after rituximab maintenance therapy.In July 2023,the biopsy of lymph node tissue was clearly diagnosed as cHL,and the transformation of FL into cHL was considered.After 2courses of chemotherapy with ABVD regimen,the disease was assessed as stable disease,considering the poor efficacy,the regimen was changed to BV+AVD.After 2courses of chemotherapy,CT indicated that multiple lymph nodes were significantly reduced,the patient developed severe lung infection,and died after the anti-infection treatment failed.cHL transformed by FL is sensitive to brentuximab vedotin.In the future,for such patients,it is also feasible to attempt a combination of brentuximab vedotin with PD-1monoclonal antibody or a mild chemotherapy regimen.

关 键 词：滤泡性淋巴瘤 经典霍奇金淋巴瘤 维布妥昔单抗 转化 

分 类 号：R733.1[医药卫生—肿瘤]