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B细胞淋巴瘤的当前治疗方法及未来展望

Current treatment approach and future perspectives in B cell lymphoma.

作者信息

Yamauchi Nobuhiko, Maruyama Dai

机构信息

Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

出版信息

Int J Hematol. 2025 Mar;121(3):342-355. doi: 10.1007/s12185-024-03879-w. Epub 2024 Nov 21.

Abstract

Diffuse large B cell lymphoma (DLBCL) and follicular lymphoma (FL) represent the two major subtypes of mature B cell lymphoma. A deeper understanding of tumor biology, as well as molecular classification characterized by targetable gene alterations, and the introduction of novel treatment options, including targeted drugs (e.g., antibody-drug conjugates and small molecules [e.g., Bruton tyrosine kinase inhibitor]) and immune therapies (e.g., chimeric antigen receptor [CAR] T cell therapy and bispecific antibody [BsAb]), has changed the treatment paradigms for DLBCL and FL. In clinical practice, however, treatment regimens are determined mainly based on prior treatment history, duration of response after previous treatment, patient age, and patient frailty because there have been few randomized trials to inform treatment selection for patients with relapsed or refractory disease and because there is no single prognostic index that guides suitable treatment for each patient. In this review, we summarize the treatment options for DLBCL and FL and discuss the treatment strategies for these two subtypes. We also discuss future perspectives for the treatment of these subtypes.

摘要

弥漫性大B细胞淋巴瘤(DLBCL)和滤泡性淋巴瘤(FL)是成熟B细胞淋巴瘤的两种主要亚型。对肿瘤生物学的深入理解,以及以可靶向基因改变为特征的分子分类,还有新治疗方案的引入,包括靶向药物(如抗体-药物偶联物和小分子[如布鲁顿酪氨酸激酶抑制剂])和免疫疗法(如嵌合抗原受体[CAR] T细胞疗法和双特异性抗体[BsAb]),已经改变了DLBCL和FL的治疗模式。然而,在临床实践中,治疗方案主要根据既往治疗史、既往治疗后的缓解持续时间、患者年龄和患者虚弱程度来确定,因为很少有随机试验为复发或难治性疾病患者的治疗选择提供依据,而且没有单一的预后指标能指导为每个患者选择合适的治疗方法。在这篇综述中,我们总结了DLBCL和FL的治疗选择,并讨论了这两种亚型的治疗策略。我们还讨论了这些亚型治疗的未来前景。

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