Liu Ying, Sun Jie, Tuo Kangxin
The Second People's Hospital of Guiyang, The Second Guiyang Hospital Affiliated to Guizhou Medical University, Guiyang, China.
Case Rep Oncol. 2023 Apr 14;16(1):227-233. doi: 10.1159/000529315. eCollection 2023 Jan-Dec.
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal non-Hodgkin lymphoma. The predominant subtype is diffuse large B-cell lymphoma (DLBCL), and no systematic lesion is identified at diagnosis. BTKi (Bruton's tyrosine kinase inhibitor) has demonstrated significant clinical activity in DLBCL. We retrospectively reported on 2 patients who began with memory deterioration or right limb movement disabilities. A cranial magnetic resonance imaging (MRI) scan and a brain biopsy were used to diagnose PCNSLs. Middle-dose methotrexate (MD-MTX) regimens were initiated for induction treatment. Zanubrutinib was chosen as the maintenance regimen due to the patients' inability to tolerate continuous MTX regimens. For 1 patient, he achieved sustained complete remission (CR) demonstrated by MRI. Another patient achieved partial remission (PR). The two patients are both alive until now. We successfully extended the PFS and OS in elderly PCNSL patients treated with zanubrutinib.
原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的侵袭性结外非霍奇金淋巴瘤。主要亚型为弥漫性大B细胞淋巴瘤（DLBCL），诊断时未发现系统性病变。布鲁顿酪氨酸激酶抑制剂（BTKi）在DLBCL中已显示出显著的临床活性。我们回顾性报告了2例以记忆减退或右肢运动障碍起病的患者。通过头颅磁共振成像（MRI）扫描和脑活检诊断为PCNSL。采用中剂量甲氨蝶呤（MD-MTX）方案进行诱导治疗。由于患者无法耐受持续的MTX方案，选择泽布替尼作为维持方案。1例患者经MRI显示达到持续完全缓解（CR）。另一例患者达到部分缓解（PR）。两名患者至今均存活。我们成功地延长了接受泽布替尼治疗的老年PCNSL患者的无进展生存期（PFS）和总生存期（OS）。
