经全身可穿透中枢神经系统的药物治疗后缓解的继发性中枢神经系统骨髓瘤。
Secondary CNS myeloma with remission after systemic CNS-penetrating agents.
作者信息
Fernandez Luis G, Oyon Daniel Eduardo, Gondi Vinai, Grimm Sean, Khan Osaama H
机构信息
Department of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Northwestern Medicine Proton Center, Warrenville, Illinois, USA.
出版信息
Neurooncol Adv. 2022 Jul 1;4(1):vdac106. doi: 10.1093/noajnl/vdac106. eCollection 2022 Jan-Dec.
BACKGROUND
CNS myeloma is a rare manifestation of multiple myeloma and is often associated with a dismal prognosis; however, cases are increasing in frequency as overall survival improves for MM. There is currently no standardized treatment for CNS myeloma; however, different chemotherapy and radiotherapy regimens have been described.
METHODS
We had previously reported on the efficacy of proton-based craniospinal irradiation in a patient with CNS myeloma; here we present a patient with a history of extramedullary plasmacytoma, 10 years in remission status post standard systemic chemotherapy, with biopsy-proven CNS myeloma successfully treated with systemic chemotherapy as a first-line treatment.
RESULTS
The patient achieved clinical and radiographic remission on 2 separate occasions with systemic chemotherapy alone.
CONCLUSIONS
This case demonstrates that systemically administered agents may have activity in CNS myeloma. Further investigations are necessary to establish the optimal combination of agents and treatment schedules.
背景
中枢神经系统骨髓瘤是多发性骨髓瘤的一种罕见表现，通常预后不佳；然而，随着多发性骨髓瘤总体生存率的提高，此类病例的发生频率正在增加。目前尚无针对中枢神经系统骨髓瘤的标准化治疗方法；不过，已有不同的化疗和放疗方案被描述。
方法
我们此前曾报道过质子束颅脊髓照射治疗一名中枢神经系统骨髓瘤患者的疗效；在此，我们介绍一名有髓外浆细胞瘤病史的患者，在接受标准全身化疗后缓解状态达10年，经活检证实的中枢神经系统骨髓瘤经一线全身化疗成功治愈。
结果
该患者仅通过全身化疗就分别两次实现了临床和影像学缓解。
结论
本病例表明，全身给药的药物可能对中枢神经系统骨髓瘤有活性。有必要进一步研究以确定药物的最佳组合和治疗方案。
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