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普拉曲沙对一名有自体干细胞移植史的复发/难治性外周T细胞淋巴瘤患者诱导出持久缓解:1例接受普拉曲沙治疗3年以上患者的病例报告

Pralatrexate induced durable response in a relapsed/refractory peripheral T-cell lymphoma patient with a history of autologous stem cell transplantation: Case report of a patient followed-up over 3 years under pralatrexate treatment.

作者信息

Merdin Alparslan, İskender Dicle, Ulu Bahar Uncu, Doğan Mehmet, Çakar Merih Kizil, Dal Mehmet Sinan, Altuntaş Fevzi

机构信息

Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey.

Department of Pathology, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey.

出版信息

Medicine (Baltimore). 2019 Jul;98(30):e16482. doi: 10.1097/MD.0000000000016482.

Abstract

RATIONALE

Relapsed or refractory peripheral T-cell lymphomas are aggressive diseases. Pralatrexate is an antimetabolite. Hereby, we are reporting a pralatrexate induced durable response in a relapsed/refractory peripheral T-Cell lymphoma patient with a history of autologous stem cell transplantation.

PATIENT CONCERNS

A male patient born in February 1947 was diagnosed with lymphoma based on his cervical lymph node excisional biopsy.

DIAGNOSES

He was diagnosed with PTCL-NOS on February 19, 2013.

INTERVENTIONS

The patient received 6 cycles of CHOP (Cyclophosphamide, doxorubicine, vincristine, methylprednisolone) chemotherapy, which achieved a complete remission. The patient underwent autologous stem cell transplantation in December 2013. After relapse was detected in the third month of the transplantation, the patient was treated with 2 cycles of ViGePP (vinorelbine, gemcitabine, procarbazine, prednisone/ methylprednisolone) chemotherapy. The patient was considered refractory to treatment after the ViGePP chemotherapy, and he was given brentuximab vedotin. Once a full response to treatment was achieved after 2 cycles, the patient received 6 cycles of brentuximab vedotin treatment. After 6 cycles, a skin biopsy was performed and the patient was diagnosed with relapsed/refractory PTCL-NOS. Pralatrexate therapy was then started on February 1, 2016 at a dose of 30 mg/m once weekly for 6 weeks in 7-week cycles.

OUTCOMES

The patient responded to pralatrexate treatment. And he has been under pralatrexate treatment over 3 years.

LESSONS

Pralatrexate should also be kept in mind as a treatment alternative in relapsed or refractory peripheral T-cell lymphoma patients.

摘要

原理

复发或难治性外周T细胞淋巴瘤是侵袭性疾病。普拉曲沙是一种抗代谢物。在此,我们报告了一例有自体干细胞移植史的复发/难治性外周T细胞淋巴瘤患者经普拉曲沙治疗后获得持久缓解。

患者情况

一名1947年2月出生的男性患者,根据颈部淋巴结切除活检被诊断为淋巴瘤。

诊断

2013年2月19日,他被诊断为非特指外周T细胞淋巴瘤(PTCL-NOS)。

干预措施

患者接受了6个周期的CHOP(环磷酰胺、多柔比星、长春新碱、甲泼尼龙)化疗,实现了完全缓解。2013年12月患者接受了自体干细胞移植。在移植后第三个月检测到复发后,患者接受了2个周期的ViGePP(长春瑞滨、吉西他滨、丙卡巴肼、泼尼松/甲泼尼龙)化疗。ViGePP化疗后患者被认为治疗无效,随后给予了本妥昔单抗治疗。2个周期后一旦实现完全缓解,患者接受了6个周期的本妥昔单抗治疗。6个周期后进行了皮肤活检,患者被诊断为复发/难治性PTCL-NOS。然后于2016年2月1日开始普拉曲沙治疗,剂量为30mg/m²,每周一次,共6周,每7周为一个周期。

结果

患者对普拉曲沙治疗有反应。他接受普拉曲沙治疗已超过3年。

经验教训

对于复发或难治性外周T细胞淋巴瘤患者,普拉曲沙也应作为一种治疗选择予以考虑。

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