CAJ | 학술논문

目的分析脾边缘区淋巴瘤中枢神经系统复发患者的临床、影像学、病理学特征,评估利妥昔单抗鞘注联合静脉化疗的安全性及疗效.方法回顾性分析苏州大学附属第一医院血液科收治的1例脾边缘区淋巴瘤中枢神经系统复发患者的临床、影像学、病理学及治疗资料,并复习相关文献.结果根据骨髓细胞形态学、免疫学、细胞遗传学和分子遗传学(MICM)分型、脾脏病理、PET-CT及实验室检查(乳酸脱氢酶)等,患者明确诊断为脾边缘区淋巴瘤Ⅳ期B组,国际预后指数(IPI)和年龄调整的国际预后指数(aaIPI)均为中高危组.经过一线治疗,患者达到完全缓解.但随后出现中枢神经系统复发,予利妥昔单抗鞘注联合静脉化疗治疗后,中枢病灶消失.结论脾边缘区淋巴瘤属于低度恶性淋巴瘤,合并中枢神经系统复发十分罕见.利妥昔单抗鞘注联合静脉化疗对本例患者是安全的,且获得很好的临床疗效.
목적 분석비변연구림파류중추신경계통복발환자적림상、영상학、병이학특정,평고리타석단항초주연합정맥화료적안전성급료효.방법 회고성분석소주대학부속제일의원혈액과수치적1례비변연구림파류중추신경계통복발환자적림상、영상학、병이학급치료자료,병복습상관문헌.결과 근거골수세포형태학、면역학、세포유전학화분자유전학(MICM)분형、비장병리、PET-CT급실험실검사(유산탈경매)등,환자명학진단위비변연구림파류Ⅳ기B조,국제예후지수(IPI)화년령조정적국제예후지수(aaIPI)균위중고위조.경과일선치료,환자체도완전완해.단수후출현중추신경계통복발,여리타석단항초주연합정맥화료치료후,중추병조소실.결론 비변연구림파류속우저도악성림파류,합병중추신경계통복발십분한견.리타석단항초주연합정맥화료대본례환자시안전적,차획득흔호적림상료효.
Objective To explore the clinical characteristics,pathological features,therapy and prognosis of a case of splenic marginal zone lymphoma (SMZL) with central recurrence,evaluation the safety and efficacy of rituximab intrathecal injection combined with intravenous chemotherapy.Methods Retrospectively analyze the case of SMZL with the central recurrence,and review the relevant literatures.Results According to the tests of MICM of bone marrow,spleen pathology,PET-CT and laboratory examination (LDH),patient was diagnosed as SMZL,IV group B,IPI and aaIPI was high risk group.After first-line therapy,the patient achieved complete remission.But then the central nervous system relapsed.The patients was treated with rituximab intrathecal injection combined with intravenous chemotherapy,the central focus disappeared.Conclusion SMZL belongs to low-grade lymphoma,which combined with central nervous system relapse is very rare.Rituximab intrathecal injection combined with intravenous chemotherapy in the treatment of the patients is safe to use,and have good clinical efficacy.