中枢神经系统在扩散大B细胞淋巴瘤中的预防:证据告诉我们什么?
Jeffrey Lantz1, Craig A Portell1, Emily C Ayers1
1Division of Hematology and Oncology and Comprehensive Cancer Center, Department of Medicine, University of Virginia School of Medicine; Charlottesville, VA, USA.
Blood reviews
|May 31, 2023
概括
扩散型大b细胞淋巴瘤 (DLBCL) 中的中枢神经系统 (CNS) 复发是罕见但严重的. 本综述审查了中枢神经系统预防与DLBCL患者的第一线治疗的有效性.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 神经学 神经学
背景情况:
- 由于扩散型大b细胞淋巴瘤 (DLBCL) 引起的中枢神经系统 (CNS) 的二级感染是一种罕见但严重的并发症.
- 标准的第一线修仙药,环胺,多克索鲁比辛,温克里斯和普雷迪尼松 (R-CHOP) 治疗不能有效地穿透血脑屏障.
研究的目的:
- 审查和综合有关中枢神经系统预防在接受一线治疗的DLBCL患者有用性的现有数据.
- 评估有关DLBCL中中枢神经系统复发预防的现有实践和证据.
主要方法:
- 对现有文献进行系统审查.
- 分析非随机,回顾性数据和最近的现实世界的证据.
- 对接受一线治疗的DLBCL患者中中枢神经系统预防的综合研究.
主要成果:
- 目前用于预测中枢神经系统复发的风险模型是不准确的.
- 支持中枢神经系统预防的现有数据主要基于不一致的,非随机的结果.
- 缺乏评估中枢神经系统预防有效性的前性随机研究.
结论:
- 在DLBCL中预防中枢神经系统复发的最佳策略仍然不确定.
- 需要进一步进行高质量的研究,包括随机试验,以澄清中枢神经系统预防的作用和方法.
- 对DLBCL中枢神经系统预防的当前做法可能需要根据不断变化的证据重新评估.
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