BTK抑制剂联合基础化疗治疗初诊双表达弥漫性大B细胞淋巴瘤5例临床分析
Clinical analysis of BTK inhibitors combined with basic chemotherapy in newly diagnosed double expression diffused large B cell lymphoma
杨丹 1李凤 1杨斐斐 1赵有财 2徐燕丽 1张学忠 1张秀群1
作者信息
- 1. 南京医科大学附属南京医院(南京市第一医院)血液科,江苏南京 210006
- 2. 南京医科大学附属南京医院(南京市第一医院)病理科,江苏南京 210006
- 折叠
摘要
目的 探究BTK抑制剂联合基础化疗对初诊双表达弥漫性大B细胞淋巴瘤(DLBCL)的临床效果.方法 回顾性分析2020年11月至2022年3月南京医科大学附属南京医院收治的5例初诊MYC和BCL2双表达DLBCL患者.对患者进行病史采集,行常规检查以及PET-CT、骨髓细胞形态学、免疫分型、染色体检测和组织学的形态学、免疫组织化学检查、荧光免疫杂交(FISH)等专科检查,根据患者临床表现、实验室检查结果对患者进行诊断,并给予患者BTK为基础的联合治疗.结果 首次初诊5例MYC和BCL2双表达DLBCL患者,其中2例为高级别B细胞淋巴瘤非特指型(HGBL,NOS),2例为CD5阳性双表达DLBCL患者;5例患者均给予BTK为基础的联合化疗,3个疗程后中期评估4例达完全缓解,1例患者2疗程后中枢复发而死亡;4例患者完成6个疗程联合治疗及2个疗程巩固治疗,其中1例患者接受自体造血干细胞移植,所有患者治疗期间均给予鞘内注药预防中枢侵犯,截止2023年10月,中位随访时间为31个月,4例患者均为完全缓解状态.结论 MYC和BCL2双表达DLBCL患者使用BTK抑制剂联合基础化疗治疗效果尚佳且安全性高,但需扩大样本量进一步验证.
Abstract
Objective To explore the clinical effect of BTK inhibitor combined with basic chemotherapy on newly diagnosed double-expressing diffuse large B-cell lymphoma(DLBCL).Methods Five cases of newly diagnosed MYC and BCL2 double-expressing DLBCL patients admitted to Nanjing First Hospital from November 2020 to March 2022 were retrospectively collected as research subjects.The patient's medical history is collected,and routine examinations,as well as PET-CT,bone marrow cell morphology,immunophenotyping,chromosomal detection and histological morphology,immunohistochemical examination,FISH and other specialized examinations are carried out.Results Five patients with MYC and BCL2 double-expressing DLBCL were initially diagnosed,of which 2 were high-grade B-cell lymphoma with not otherwise specified(HGBL,NOS),2 were CD5-positive double-expressing DLBCL patients.5 patients were given BTK-based combined chemotherapy,After three course of treatment,4 patients achieved CR,1 patient died after two course of treatment with central relapse,4 patients completed 6 courses of combination therapy and 2 courses of consolidation therapy,1 patient received autologous hematopoietic stem cell transplantation,all patients received intrathecal injection to prevent central invasion during treatment.As of October 2023,the median follow-up time was 31 months,and all 4 patients were in complete remission.Conclusion DLBCL patients with double expression of MYC and BCL2 were treated with BTK inhibitor combined with basic chemotherapy has a good effect and the safety is high,but the sample size needs to be expanded for further exploration in the later stage.
关键词
弥漫性大B细胞淋巴瘤/双表达/BTK抑制剂Key words
diffuse large B-cell lymphoma/double-expressing/BTK inhibitor引用本文复制引用
基金项目
南京市卫生科技发展项目(YKK19082)
出版年
2024
国家科技期刊平台
NSTL
万方数据