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[我们治疗霍奇金淋巴瘤患者的经验]

[Our experience with the treatment of Hodgkin lymphoma patients].

作者信息

Illés Árpád, Garai Ildikó, Miltényi Zsófia

机构信息

1 Debreceni Egyetem, Általános Orvostudományi Kar, Belgyógyászati Intézet, Hematológiai Tanszék Debrecen, Nagyerdei krt. 98., 4032 Magyarország.

2 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Orvostudományok Doktori Iskola Debrecen Magyarország.

出版信息

Orv Hetil. 2023 Mar 19;164(11):403-410. doi: 10.1556/650.2023.32736.

Abstract

Overall and disease-free survival of Hodgkin lymphoma patients has improved significantly since the 2000s. This is due to the use of ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) polychemotherapy and modern radiotherapy. In recent years, further diagnostic and therapeutic changes have been made, which further improve patients' survival. The most significant role in this is the improvement of diagnostics, such as the 18FDG-PET/CT, which is now routinely used repeatedly during treatment, and the response-adapted treatment(s) based on it. The main role of ABVD treatment in first-line treatment is still clear, but the combination of anti-CD30 monoclonal antibody (brentuximab vedotin) and AVD (adriamycin, vinblastine, dacarbazine) is already available as a targeted treatment for patients at higher risk. The role of autologous hematopoietic stem cell transplantation in the treatment of high-risk, relapsing/refractory patients is still clear, but the new, targeted innovative drugs (brentuximab vedotin, pembrolizumab) can already be used in the previous salvage treatments. New therapeutic options have new side effects, which must be taken into account during treatment (and after it). In our summary, we present these new diagnostic and therapeutic approaches, based on our own practice and experience. Orv Hetil. 2023; 164(11): 403-410.

摘要

自21世纪以来,霍奇金淋巴瘤患者的总生存率和无病生存率有了显著提高。这得益于ABVD(阿霉素、博来霉素、长春花碱、达卡巴嗪)多药化疗和现代放疗的应用。近年来,在诊断和治疗方面又有了进一步的变革,这进一步提高了患者的生存率。其中最重要的是诊断方法的改进,如18FDG-PET/CT,现在在治疗期间常规反复使用,并在此基础上进行适应性治疗。ABVD治疗在一线治疗中的主要作用仍然明确,但抗CD30单克隆抗体(本妥昔单抗)与AVD(阿霉素、长春花碱、达卡巴嗪)联合使用已成为高危患者的靶向治疗方法。自体造血干细胞移植在高危、复发/难治性患者治疗中的作用仍然明确,但新型靶向创新药物(本妥昔单抗、帕博利珠单抗)已可用于先前的挽救治疗。新的治疗方法有新的副作用,在治疗期间(及之后)必须予以考虑。在我们的综述中,我们基于自身的实践和经验介绍这些新的诊断和治疗方法。《匈牙利医学周报》。2023年;164(11): 403 - 410。

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