Rinaldi Ikhwan, Muthalib Abdul, Gondhowiardjo Soehartati, Setiawan Tjondro, Gunawan Andhika, Susanto Nelly, Magdalena Lingga, Winston Kevin, Disamantiji Ashila, Wirawan Bintang
Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia.
Department of Internal Medicine Gading Pluit Hospital Jakarta Indonesia.
Clin Case Rep. 2024 Mar 1;12(3):e8409. doi: 10.1002/ccr3.8409. eCollection 2024 Mar.
Optimized treatments for relapsed isolated CNS lymphoma (RI-SCNSL) remains under investigation. Temozolomide combination-based therapy, which is often used in glioblastoma may be used as potential treatment in RI-SCNSL.
One of the most common types of non-Hodgkin lymphoma (NHL) is diffuse large B-cell lymphoma (DLBCL). Despite advances in treatment, relapsed isolated CNS lymphoma (RI-SCNSL) from DLBCL remains an issue. The optimal approach in RI-SCNSL remains an area of active investigation as currently there is no high level of evidence for the treatments due to lack of randomized studies. In this case report, we present a DLBCL patient with CNS recurrence treated radiotherapy and intrathecal methotrexate (MTX) followed by intravenous high-dose MTX, rituximab, and temozolomide. To the best of our knowledge, this is the first case report describing RI-SCNSL treated with the regiments above which also include temozolomide which is used for glioblastoma.
复发性孤立性中枢神经系统淋巴瘤（RI-SCNSL）的优化治疗仍在研究中。常用于胶质母细胞瘤的基于替莫唑胺的联合疗法可能用作RI-SCNSL的潜在治疗方法。
最常见的非霍奇金淋巴瘤（NHL）类型之一是弥漫性大B细胞淋巴瘤（DLBCL）。尽管治疗取得了进展，但DLBCL复发的孤立性中枢神经系统淋巴瘤（RI-SCNSL）仍然是一个问题。RI-SCNSL的最佳治疗方法仍是一个积极研究的领域，因为目前由于缺乏随机研究，治疗缺乏高水平证据。在本病例报告中，我们介绍了一名中枢神经系统复发的DLBCL患者，接受了放射治疗和鞘内注射甲氨蝶呤（MTX），随后静脉注射高剂量MTX、利妥昔单抗和替莫唑胺。据我们所知，这是第一例描述用上述方案治疗RI-SCNSL的病例报告，该方案还包括用于胶质母细胞瘤的替莫唑胺。
