原发中枢神经系统淋巴瘤诊治进展
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国家自然科学基金(81770166)


Progress in diagnosis and treatment of primary central nervous system lymphoma
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    摘要:

    原发中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)是一种罕见的侵袭性结外非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL),通常局限于大脑、眼睛、脊髓或软脑膜而无全身性受累。PCNSL的诊断、治疗和预后与其他类型NHL不同。传统治疗方法如手术、全脑放疗、以大剂量甲氨蝶呤为基础的化疗以及利妥昔单抗等,虽然初始缓解率较高,但缓解持续时间短、复发率高、神经系统不良反应较大,总体生存期短。此外,对于复发/难治PCNSL,传统治疗方法效果并不能令人满意,因此,寻找更加有效、持续时间更长的治疗方法便成了当务之急。目前,随着淋巴瘤分子机制研究不断加深、免疫治疗药物及手段的不断发展,新的治疗方法包括布鲁顿酪氨酸激酶(Bruton tyrosine kinase,BTK)抑制剂、程序性死亡蛋白1(programmed cell death protein 1,PD-1)抑制剂和免疫调节剂等为PCNSL的治疗带来曙光。

    Abstract:

    Primary central nervous system lymphoma(PCNSL)is a rare and and aggressive extranodal non-Hodgkin lymphoma(NHL),which is usually confined to the brain,eyes,spinal cord or leptomeninges without systemic involvement. The diagnosis,treatment and prognosis of PCNSL are different from other types of NHL. Traditional treatment methods,such as surgery,whole brain radiotherapy,chemotherapy based on high dose methotrexate and rituximab,can leads to high initial response rate,but the duration of response is short,the recurrence rate is high,the neurotoxicity are large,and the overall survival period is poor. In addition,the effect of traditional treatment for recurrent/refractory PCNSL patients is not satisfactory,so it is urgent to find a more effective and longer lasting treatment. At present,with the development of the research on the molecular mechanism and the immunotherapies,novel treatments,including Burton tyrosine kinase(BTK)inhibitors,programmed cell death protein 1(PD-1)inhibitors and immunomodulators,bring new light to PCNSL patients.

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赵苗苗,徐 卫.原发中枢神经系统淋巴瘤诊治进展[J].南京医科大学学报(自然科学版),2020,(12):1879-1884

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  • 收稿日期:2019-11-27
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  • 在线发布日期: 2021-01-04
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