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蕈样肉芽肿的管理:聚焦于维布妥昔单抗

[Management of mycosis fungoide : focus on brentuximab vedotin].

作者信息

Lebas E, Collins P, Bonnet C, Libon F, Dezfoulian B, Nikkels A F

机构信息

) Service de Dermatologie, CHU Liège, Belgique.

Service de Dermatopathologie, CHU Liège, Belgique.

出版信息

Rev Med Liege. 2021 Apr;76(4):224-231.

Abstract

Recently, brentuximab vedotin (BV) (Adcetris®) obtained the reimbursement in Belgium for the treatment of the primary cutaneous NKT-cell lymphomas mycosis fungoides (MF), large cell anaplastic lymphoma and lymphomatoid papulosis type A. BV is a monoclonal antibody directed against the CD30 expressed on tumoral T cells. The inhibition of this pathway releases the process of apoptosis leading to the cell death of the tumoral cells. BV is reimbursed after the use of another systemic treatment without success and if the number of CD30 positive atypical T-cells is larger than 10 %. BV is administered intravenously every 3 weeks with a dosing of 1,8 mg/kg with a maximum of 16 courses. The response rates exceed 75 %. In some instances, interesting treatment responses have been observed with BV in CD30 negative patients. The principal adverse effects are neutropenia and peripheral neuropathy. Two patients are presented with longstanding multi-resistant MF that were successfully treated with BV.

摘要

最近,本妥昔单抗(BV)(商品名:安适利®)在比利时已获批用于报销治疗原发性皮肤NKT细胞淋巴瘤蕈样肉芽肿(MF)、间变性大细胞淋巴瘤和A型淋巴瘤样丘疹病。BV是一种针对肿瘤T细胞上表达的CD30的单克隆抗体。对该信号通路的抑制可启动凋亡过程,导致肿瘤细胞死亡。在使用其他全身治疗无效且CD30阳性非典型T细胞数量大于10%的情况下,BV可予以报销。BV每3周静脉注射一次,剂量为1.8mg/kg,最多16个疗程。缓解率超过75%。在某些情况下,BV在CD30阴性患者中也观察到了令人感兴趣的治疗反应。主要不良反应是中性粒细胞减少和周围神经病变。本文报告了2例长期多重耐药的MF患者,经BV治疗取得成功。

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