血液恶性瘤和血液造血干细胞移植
Chiara Briani1, Andrea Visentin2
1Department of Neurosciences, Neurology Unit, University of Padova, Padova, Italy.
Handbook of clinical neurology
|March 17, 2024
概括
在血液癌症中,瘤神经综合征 (PNS) 是罕见的,但淋巴瘤是最常见的. 治疗包括癌症治疗和免疫调节,在边缘脑炎中获得最佳结果.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 麻性神经综合征 (PNS) 是血液性恶性瘤的罕见并发症.
- 淋巴瘤是与PNS相关的最常见的血液癌症.
- 高风险抗体通常不存在,除了特殊情况下,如小脑退行症中的抗Tr/DNER.
研究的目的:
- 审查血液性恶性瘤和PNS之间的关联.
- 突出显示关键的抗体和诊断标记.
- 讨论在血液癌症中PNS的当前治疗策略.
主要方法:
- 在血液恶性瘤中对瘤神经系统综合征的文献综述.
- 对抗体关联和诊断标记物的分析.
- 治疗方法的总结,包括癌症治疗,免疫调节和特定干预措施.
主要成果:
- 周围神经系统PNS,特别是脱髓化的多基基隆性神经病变,在非霍奇金淋巴瘤中可见.
- 多神经病变,有机巨变,内分泌病变,单克隆性阴膜病变,皮肤变化 (POEMS) 综合征的诊断依赖于标准和血管内皮生长因子 (VEGF).
- 治疗包括癌症治疗和免疫调节,在抗体相关的PNS中反应更好,在抗mGluR5抗体边缘性脑炎中结果更好.
结论:
- 治疗PNS的治疗方法包括癌症治疗和免疫调节疗法,在抗体相关PNS中观察到更好的反应.
- 造血干细胞移植是POEMS综合征的首要治疗方法,除了放射治疗孤立的骨质硬化病变外.
- 建议在相关的PNS中停止免疫检查点抑制剂和免疫调节治疗.
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