Bruton's tyrosine kinase inhibitor for primary central nervous system lymphoma:a clinical analysis of 16 cases
Objective:To analyze the clinical characteristics of patients with primary central nervous system lymphoma(PCNSL)treated with Bruton's tyrosine kinase(BTK)inhibitors and to explore the factors affecting the efficacy and the fol-low-up treatment experience of patients with poor efficacy.Methods:The clinical data of newly diagnosed PCNSL patients treated with BTK inhibitors(including orelabrutinib,zanubrutinib)combined with conventional chemotherapy were retro-spectively analyzed.Results:Among the 16 patients with PCNSL,13 were males and 3 were females,with a median age of 62.5 years.The lesions were mainly multiple,accounting for 56％.The main pathological type was non-germinal center B cell(62％),and double expression type(38％).The biochemical data of cerebrospinal fluid were found in 9 patients,and the protein level of cerebrospinal fluid was elevated in 78％.A total of 7 patients had gene sequencing results,including MYD88 mutation(57％)and CD79B mutation(43％).Among the 16 patients,9(56％)received orelabrutinib combined with conventional chemotherapy,and 7(44％)received zanubrutinib combined with conventional chemotherapy.The overall response rate(ORR)of the 16 patients was 69％.Among the 5 patients with poor efficacy,4 had multiple lesions,4 had double expression type,and 3 had MYD88 mutation.Two patients underwent hematopoietic stem cell transplantation followed by chimeric antigen receptor T cell therapy(auto-HSCT+CAR-T)and achieved complete remission.Conclusion:The ORR of PCNSL patients treated with BTK inhibitor combined with conventional chemotherapy is 69％.Multiple lesions,double expression and MYD88 mutation may be the factors of poor efficacy.The auto-HSCT+CAR-T may be a feasible follow-up treatment for patients with poor response to PCNSL treated by BTK inhibitors combined with conventional chemotherapy.
Primary central nervous system lymphomaBruton's tyrosine kinase inhibitorsClinical features
NETL
NSTL
万方数据
