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扩散型大B细胞淋巴瘤的发展随机导致了耐火性古典霍奇金淋巴瘤患者的救命治疗
Minako Mori1, Tomomi Sakai1, Tomomi Oka1
1Department of Hematology, NHO Kyoto Medical Center, Japan.
Internal medicine (Tokyo, Japan)
|September 18, 2024
概括
这项案例研究强调了再活检在淋巴瘤管理中的关键作用. 及时的再活检对于准确诊断复发或进展至关重要,确保霍奇金淋巴瘤和扩散大B细胞淋巴瘤患者及时有效调整治疗.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 内部医学 内部医学
背景情况:
- 经典霍奇金淋巴瘤 (cHL) 可以转化为其他淋巴瘤亚型.
- 治疗耐药性和疾病进展需要仔细监测和诊断重新评估.
研究的目的:
- 报告一个古典霍奇金淋巴瘤转变为扩散型大B细胞淋巴瘤的病例.
- 为了强调再活检在治疗复发性或耐药性淋巴瘤中的临床意义.
主要方法:
- 一名65岁的男性患者被诊断患有cHL混合细胞性.
- 用ABVD,布伦图西马布维多丁和尼沃卢马布进行连续治疗.
- 在食管胃二透镜检查期间通过再活检诊断扩散性大B细胞淋巴瘤 (DLBCL).
- 用Rituximab-CHOP疗法进行治疗.
主要成果:
- 在ABVD之后的初始完全代谢缓解 (CMR),其次是复发.
- 部分缓解brentuximab vedotin,然后是系统性复发.
- 与尼沃卢马布的第二次CMR,但随后的疾病进展超过4年.
- 在DLBCL治疗中,Rituximab-CHOP治疗成功实现了CMR.
结论:
- 淋巴瘤的转变可以发生,尽管最初的治疗反应.
- 重复活检对于识别组织学转变和指导后续治疗至关重要.
- 复发性/耐药性淋巴瘤的有效管理需要警的诊断评估和量身定制的治疗策略.
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