白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2014年
10期
586-588,592
,共4页
原发性睾丸淋巴瘤%原发性中枢神经系统淋巴瘤%欧洲血液学会年会
原髮性睪汍淋巴瘤%原髮性中樞神經繫統淋巴瘤%歐洲血液學會年會
원발성고환림파류%원발성중추신경계통림파류%구주혈액학회년회
Primary testicular lymphoma%Primary central nervous system lymphoma%European Hematology Association annual congress
原发性睾丸淋巴瘤(PTL)是一类少见的结外淋巴瘤,进展迅速,预后不良.对于早期局限性病变,可联合应用以蒽环类为基础的化疗、利妥昔单抗、鞘内注射甲氨蝶呤后行对侧睾丸放疗等.中枢神经系统复发风险极高,鞘内注射甲氨蝶呤可能是最好的防治方法.原发性中枢神经系统淋巴瘤(PCNSL)是一种侵袭性淋巴瘤,预后较差,对现有非霍奇金淋巴瘤标准治疗方案均不敏感,甲氨蝶呤联合阿糖胞苷是目前的标准诱导方案.抗CD20单克隆抗体虽然脑脊液含量低,但仍有治疗效果.高剂量化疗联合自体造血干细胞移植缓解率高,3年总生存率可达87%.
原髮性睪汍淋巴瘤(PTL)是一類少見的結外淋巴瘤,進展迅速,預後不良.對于早期跼限性病變,可聯閤應用以蒽環類為基礎的化療、利妥昔單抗、鞘內註射甲氨蝶呤後行對側睪汍放療等.中樞神經繫統複髮風險極高,鞘內註射甲氨蝶呤可能是最好的防治方法.原髮性中樞神經繫統淋巴瘤(PCNSL)是一種侵襲性淋巴瘤,預後較差,對現有非霍奇金淋巴瘤標準治療方案均不敏感,甲氨蝶呤聯閤阿糖胞苷是目前的標準誘導方案.抗CD20單剋隆抗體雖然腦脊液含量低,但仍有治療效果.高劑量化療聯閤自體造血榦細胞移植緩解率高,3年總生存率可達87%.
원발성고환림파류(PTL)시일류소견적결외림파류,진전신속,예후불량.대우조기국한성병변,가연합응용이은배류위기출적화료、리타석단항、초내주사갑안접령후행대측고환방료등.중추신경계통복발풍험겁고,초내주사갑안접령가능시최호적방치방법.원발성중추신경계통림파류(PCNSL)시일충침습성림파류,예후교차,대현유비곽기금림파류표준치료방안균불민감,갑안접령연합아당포감시목전적표준유도방안.항CD20단극륭항체수연뇌척액함량저,단잉유치료효과.고제양화료연합자체조혈간세포이식완해솔고,3년총생존솔가체87%.
Primary testicular lymphoma (PTL) is an uncommon extranodal lymphoma,with an aggressive clinical course and poor outcome.A combined treatment with full-course anthracycline-based chemotherapy with rituximab and central nervous system prophylaxis with intrathechal methotrexate and contralateral testicular radiotherapy should be considered as the standard of care at limited stage.These patients have a very high risk of central nervous system recurrence and the addition of systemic central nervous system prophylaxis with intravenous methotrexate may be the best treatment option.Primary central nervous system lymphoma (PCNSL) is an aggressive disease with a dismal prognosis,particularly when treated with established protocols used for systemic non-Hodgkin lymphoma.Use of methotrexate in combination with cytarabine has been proposed as a standard induction regimen.The role of the anti-CD20 antibody has not yet been defined,however,phase Ⅰ and Ⅱ trials suggest its efficacy despite low penetration within the cerebrospinal fluid.High-dose chemotherapy followed by autologous stem cell transplantation has shown high remission rates with 3-year overall suvival rates of up to 87 %.