Bernard Sophie, Goldwirt Lauriane, Amorim Sandy, Brice Pauline, Brière Josette, de Kerviler Eric, Mourah Samia, Sauvageon Hélène, Thieblemont Catherine
Hemato-oncology Department, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Saint-Louis, Paris, France; Paris Diderot Université, Sorbonne Paris Cité, Paris, France;
Pharmacology Department, APHP, Hôpital Saint-Louis, Paris, France;
Blood. 2015 Oct 1;126(14):1695-8. doi: 10.1182/blood-2015-05-647834. Epub 2015 Aug 3.
The risk of central nervous system (CNS) dissemination in mantle cell lymphoma (MCL) is low and occurs late in the course of the disease. However, prognosis in such cases remains extremely poor despite high-dose antimetabolite chemotherapy. Among novel drugs used to treat relapsing MCL patients, ibrutinib, an oral inhibitor of Bruton tyrosine kinase, shows great promise. Here we report the clinical observation of 3 MCL patients with symptomatic CNS relapse treated with single-agent ibrutinib. All 3 patients had dramatic and rapid responses with almost immediate recovery from symptoms. We also confirmed that ibrutinib crosses the blood-brain barrier with parallel pharmacokinetic analyses in plasma and cerebrospinal fluid using a validated LC-MS/MS method. All responses were ongoing after 2 months to 1 year of follow-up.
套细胞淋巴瘤（MCL）发生中枢神经系统（CNS）播散的风险较低，且在疾病进程后期出现。然而，尽管采用了大剂量抗代谢物化疗，此类病例的预后仍然极差。在用于治疗复发性MCL患者的新型药物中，布鲁顿酪氨酸激酶口服抑制剂依鲁替尼显示出巨大前景。在此，我们报告3例有症状的CNS复发MCL患者接受单药依鲁替尼治疗的临床观察结果。所有3例患者均有显著且快速的反应，症状几乎立即缓解。我们还使用经过验证的液相色谱-串联质谱法（LC-MS/MS），通过血浆和脑脊液的平行药代动力学分析证实依鲁替尼可穿过血脑屏障。随访2个月至1年时，所有反应仍在持续。
