Mociková Heidi, Malikova Hana, Holesta Michal, Elturki Abdulfattah, Campr Vit, Kozak Tomas
Department of Internal Medicine and Hematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
Department of Radiology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
Am J Case Rep. 2020 Mar 14;21:e921657. doi: 10.12659/AJCR.921657.
BACKGROUND CNS involvement in Hodgkin lymphoma is rare. Despite various treatment options, median overall survival is only 13 months after diagnosis of CNS involvement in relapsed/refractory HL. CASE REPORT A 29-year-old woman with classical HL (mixed cellularity) in clinical stage IIB was treated with multilineage chemotherapy and radiotherapy without achieving a sustained complete remission. Systemic and CNS progression of HL occurred at the age of 32 years and the patient received 2 cycles of brentuximab vedotin with bendamustine alternating with 2 cycles of high-dose methotrexate-based treatment and achieved partial remission. She then underwent autologous stem cell transplantation followed by brentuximab vedotin consolidation. The disease progressed and the patient died 6 months after the last dose of brentuximab vedotin. CONCLUSIONS We demonstrated a durable response to brentuximab vedotin-based chemotherapy in a patient with refractory Hodgkin lymphoma with CNS involvement. Prognosis of these patients is poor and new treatment options are needed.
背景 中枢神经系统受累于霍奇金淋巴瘤较为罕见。尽管有多种治疗选择,但在复发/难治性霍奇金淋巴瘤患者诊断出中枢神经系统受累后,中位总生存期仅为13个月。病例报告 一名29岁临床IIB期经典型霍奇金淋巴瘤(混合细胞型)女性患者接受了多线化疗和放疗,但未实现持续完全缓解。霍奇金淋巴瘤在32岁时出现全身和中枢神经系统进展,患者接受了2个周期的本妥昔单抗联合苯达莫司汀,与2个周期的基于大剂量甲氨蝶呤的治疗交替进行,并实现了部分缓解。随后她接受了自体干细胞移植,之后进行本妥昔单抗巩固治疗。疾病进展,患者在最后一剂本妥昔单抗治疗6个月后死亡。结论 我们证明了一名难治性霍奇金淋巴瘤合并中枢神经系统受累患者对基于本妥昔单抗的化疗有持久反应。这些患者的预后较差,需要新的治疗选择。