Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa.
Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.
J Pediatr Hematol Oncol. 2021 Aug 1;43(6):e864-e866. doi: 10.1097/MPH.0000000000001914.
Central nervous system (CNS) involvement in anaplastic large cell lymphoma (ALCL) is uncommon. CNS prophylaxis is not regularly included in second-line treatments for patients who develop CNS-negative relapses. We report a pediatric case of recurrent ALK-negative ALCL who developed isolated CNS progression during the treatment with brentuximab vedotin monotherapy. The patient achieved CNS remission after receiving the CNS-directed treatments including craniospinal irradiation. There is no evidence regarding whether brentuximab vedotin can cross the blood-brain barrier. CNS prophylaxis should be considered in high-risk patients with relapsed ALCL who receive second-line treatments containing agents with limited CNS penetration.
中枢神经系统(CNS)受累在间变性大细胞淋巴瘤(ALCL)中并不常见。对于发生 CNS 阴性复发的患者,中枢神经系统预防治疗通常不包括在二线治疗中。我们报告了一例儿童复发性 ALK 阴性 ALCL 病例,该患者在接受 Brentuximab vedotin 单药治疗期间出现孤立性 CNS 进展。该患者在接受包括全脑放疗在内的针对 CNS 的治疗后,达到 CNS 缓解。目前尚无证据表明 Brentuximab vedotin 是否可以穿透血脑屏障。对于接受二线治疗且药物对 CNS 穿透性有限的复发性 ALCL 高危患者,应考虑中枢神经系统预防治疗。