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[高危霍奇金淋巴瘤自体干细胞移植后使用维布妥昔单抗维持治疗取得成功]

[Successful treatment with brentuximab vedotin maintenance therapy after autologous stem cell transplantation in high-risk Hodgkin lymphoma].

作者信息

Ishii Kazuyoshi, Azuma Yoshiko, Konishi Akiko, Tsubokura Yukie, Yoshimura Hideaki, Hotta Masaaki, Nakanishi Takahisa, Nakaya Aya, Fujita Shinya, Satake Atsushi, Miyaji Michihiko, Ito Tomoki, Nomura Shosaku

机构信息

Department of Internal Medicine, Kansai Medical University.

出版信息

Rinsho Ketsueki. 2018;59(8):1002-1006. doi: 10.11406/rinketsu.59.1002.

Abstract

A 56-year-old woman was diagnosed with classical Hodgkin lymphoma in December 2012. She achieved complete remission (CR) with six cycles of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD). In March 2015, she experienced a relapse marked by high fever, respiratory discomfort, and pain in the left thigh owing to tumor involvement of the femur. She was treated with one cycle of brentuximab vedotin (BV), followed by irradiation of the left femoral lesion. She achieved partial remission (PR) but developed recurrence after the third cycle of BV. She achieved PR again with two cycles of standard bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) regimen; therefore, autologous stem cell transplantation (ASCT) was performed. Because the dosing interval used for BV therapy was longer than that in the recommended schedule, we could not definitively attribute her recurrence to BV resistance. Moreover, she maintained a good performance status after recurrence during subsequent cycles of BV therapy. Because of attaining PR after ASCT, she subsequently received a total of 12 BV cycles for consolidation. She achieved CR 3 months after ASCT and has remained in CR until 29 months. For patients who show relapse after initial BV therapy, retreatment with BV should be carefully considered. Patients who show relapse after achieving at least PR with initial BV therapy are potential candidates for post-ASCT BV maintenance therapy to reduce their tumor burden.

摘要

一名56岁女性于2012年12月被诊断为经典型霍奇金淋巴瘤。她通过六个周期的阿霉素、博来霉素、长春花碱和达卡巴嗪(ABVD)方案实现了完全缓解(CR)。2015年3月,她出现复发,表现为高热、呼吸不适以及因股骨受肿瘤侵犯导致的左大腿疼痛。她接受了一个周期的本妥昔单抗(BV)治疗,随后对左股骨病变进行了放疗。她达到了部分缓解(PR),但在BV第三个周期后出现复发。她通过两个周期的标准博来霉素、依托泊苷、阿霉素、环磷酰胺、长春新碱、丙卡巴肼和泼尼松(BEACOPP)方案再次达到PR;因此,进行了自体干细胞移植(ASCT)。由于BV治疗的给药间隔长于推荐方案,我们无法明确将她的复发归因于BV耐药。此外,在复发后的后续BV治疗周期中,她保持了良好的身体状况。由于ASCT后达到PR,她随后总共接受了12个周期的BV巩固治疗。她在ASCT后3个月达到CR,并且一直保持CR状态直至29个月。对于初始BV治疗后出现复发的患者,应谨慎考虑再次使用BV治疗。初始BV治疗至少达到PR后出现复发的患者是ASCT后BV维持治疗以减轻肿瘤负担的潜在候选者。

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