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老年人套细胞淋巴瘤的临床管理。

Clinical management of mantle cell lymphoma in the elderly.

机构信息

Department of Experimental Hematology, Medical University of Lodz , Lodz , Poland.

Department of Hematology, Medical University of Lodz , Lodz , Poland.

出版信息

Expert Opin Pharmacother. 2019 Oct;20(15):1893-1905. doi: 10.1080/14656566.2019.1642871. Epub 2019 Aug 2.

Abstract

: Mantle cell lymphoma (MCL) is a disease with an indolent histology, but mostly aggressive clinical course. While treatment can yield more promising results in younger patients, the disease is most diagnosed at a median age of approximately 70 years, and treatment in this group still presents a major challenge for oncohematologists. Unfortunately, due to comorbidities and poorer general status, the implementation of intensive treatment approaches with the cytarabine-based regimens and autologous stem cell transplantation is generally not possible, and the disease remains incurable, especially in elderly patients. : In this paper, the authors discuss the therapeutic options available for older patients with MCL in the first line and relapsed/refractory settings, indicating new therapeutic options, which may achieve longer remissions and overall survival. : Although great progress has been made in the treatment of MCL in recent years, there remains a need for new treatment lines which can allow improved patient outcomes. Novel agents targeting altered the signal transduction pathways in MCL cells may offer more promise than traditional chemotherapy or immunochemotherapy and are currently being tested in clinical trials.

摘要

套细胞淋巴瘤(MCL)是一种组织学惰性但临床病程多侵袭性的疾病。虽然在年轻患者中的治疗效果可能更为显著,但该病的中位诊断年龄约为 70 岁,对于肿瘤血液学家来说,该年龄组的治疗仍然是一个重大挑战。不幸的是,由于合并症和一般状况较差,基于阿糖胞苷的方案和自体干细胞移植的强化治疗方法通常无法实施,而且该病仍然无法治愈,尤其是在老年患者中。本文作者讨论了在一线和复发/难治性环境下,针对老年 MCL 患者的可用治疗选择,并指出了新的治疗选择,这些选择可能会实现更长的缓解期和总生存期。尽管近年来在 MCL 的治疗方面取得了巨大进展,但仍需要新的治疗方案来改善患者的预后。针对 MCL 细胞信号转导通路改变的新型靶向药物可能比传统化疗或免疫化疗更有前景,目前正在临床试验中进行测试。

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