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[套细胞淋巴瘤的当前治疗策略]

[Current therapeutic strategies for mantle cell lymphoma].

作者信息

Dreyling M, Schnaiter A, Schmidt C, Hoster E

机构信息

Medizinische Klinik und Poliklinik III, Klinikum der Universität München, Marchioninistr. 15, 81337, München, Deutschland.

出版信息

Internist (Berl). 2016 Mar;57(3):230-7. doi: 10.1007/s00108-016-0017-y.

Abstract

Mantle cell lymphoma is a subtype of B‑cell lymphoma with a mostly aggressive behavior and poor long-term prognosis. The choice of therapy depends on the age, performance status and risk profile of the patient. Randomized trials have confirmed the superiority of a dose-intensified induction therapy containing cytarabine followed by autologous stem cell transplantation in the first-line treatment of younger patients with a good general condition. Elderly patients benefit from a rituximab maintenance therapy after immunochemotherapy. Novel targeted therapies of the B‑cell receptor pathway with the Bruton's tyrosine kinase inhibitor ibrutinib and the mechanistic target of rapamycin (mTOR) antagonist temsirolimus as well as immunomodulatory drugs (lenalidomide) have shown promising results in relapsed disease. The proteasome inhibitor bortezomib has been approved for first-line treatment in combination with conventional chemotherapy.

摘要

套细胞淋巴瘤是B细胞淋巴瘤的一种亚型,大多具有侵袭性,长期预后较差。治疗方案的选择取决于患者的年龄、身体状况和风险特征。随机试验已证实,对于一般状况良好的年轻患者,一线治疗采用含阿糖胞苷的剂量强化诱导疗法并序贯自体干细胞移植具有优势。老年患者在免疫化疗后接受利妥昔单抗维持治疗可从中获益。新型的B细胞受体通路靶向疗法,如使用布鲁顿酪氨酸激酶抑制剂伊布替尼、雷帕霉素作用靶点(mTOR)拮抗剂替西罗莫司以及免疫调节药物(来那度胺),在复发疾病的治疗中已显示出有前景的结果。蛋白酶体抑制剂硼替佐米已获批与传统化疗联合用于一线治疗。

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