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原发性和继发性结外 NK/T 细胞淋巴瘤的中枢神经系统侵犯患者的临床分析。

Clinical analysis of patients with primary and secondary extranodal natural killer/T-cell lymphoma of central nervous system.

机构信息

Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

出版信息

Hematol Oncol. 2023 Apr;41(2):267-274. doi: 10.1002/hon.2894. Epub 2021 Jun 1.

Abstract

Extranodal natural killer (NK)/T-cell lymphoma (NKTL) is a rare non-Hodgkin lymphoma that rarely arise exclusively in or metastasizes to the central nervous system (CNS). Globally, CNS involvement of NKTL heralds a serious prognosis and there is no standard treatment. 19 of 414 patients (4.59%) with ENKL followed were diagnosed with CNS involvement between 2006 and 2020. Two patients had primary CNS (PCNS) NKTL, and 17 patients had secondary CNS (SCNS) invasion. A total of 9 patients survived and 10 patients died. The median overall survival time was 55 months, and the median survival time after CNS invasion was 17 months. The 5-year cumulative survival probability was 45.7%. In conclusion, CNS risk evaluation and prophylaxis treatment can be carried out for patients with NK/T-cell lymphoma prognostic index risk group III/IV. In terms of treatment, systemic therapy based on methotrexate combined with radiotherapy and intrathecal chemotherapy can be selected.

摘要

结外自然杀伤(NK)/T 细胞淋巴瘤(NKTL)是一种罕见的非霍奇金淋巴瘤,很少单独发生或转移至中枢神经系统(CNS)。在全球范围内,NKTL 累及中枢神经系统预示着严重的预后,目前尚无标准治疗方法。2006 年至 2020 年间,414 例结外 NK/T 细胞淋巴瘤患者中共有 19 例(4.59%)被诊断为中枢神经系统受累。其中 2 例为原发性中枢神经系统(PCNS)NKTL,17 例为继发性中枢神经系统(SCNS)侵犯。共有 9 例患者存活,10 例患者死亡。中位总生存期为 55 个月,中枢神经系统侵犯后的中位生存时间为 17 个月。5 年累积生存率为 45.7%。总之,对于 NK/T 细胞淋巴瘤预后指数风险组 III/IV 的患者,可以进行中枢神经系统风险评估和预防治疗。在治疗方面,可以选择以甲氨蝶呤为基础的全身治疗联合放疗和鞘内化疗。

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