使用布鲁顿酪氨酸激酶抑制剂治疗血液系统恶性肿瘤后发生的葡萄膜黑色素瘤。
Uveal melanoma following Bruton's tyrosine inhibitor use for the treatment of hematologic malignancies.
作者信息
Murty Tara, Lin Jonathan H, Mruthyunjaya Prithvi
机构信息
Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Department of Pathology, Stanford University, Palo Alto, CA, USA.
出版信息
Am J Ophthalmol Case Rep. 2025 May 3;38:102345. doi: 10.1016/j.ajoc.2025.102345. eCollection 2025 Jun.
PURPOSE
To report two new cases and summarize one case of uveal melanoma following treatment of hematologic malignancies with Bruton's tyrosine kinase inhibitors.
OBSERVATIONS
A 71-yearold male, with a history of Waldenstrom macroglobulinemia treated with an anti-CD20 antibody and BTKi, was diagnosed with a choroidal melanoma with intraocular metastasis. A 73-year-old female, with a history of Mantle Cell Lymphoma treated with an alkylating chemotherapy and an anti-CD20 antibody, relapse, and subsequent treatment with BTKi, was diagnosed with a uveal melanoma.
CONCLUSIONS AND IMPORTANCE
Patients being treated with BTK inhibitors may be at higher risk for the development of uveal melanoma. Based on our findings, we recommend increased surveillance of this patient population for secondary primary or metastatic uveal melanoma. Continued documentation of occurrence in conjunction with research at a molecular and cellular level are warranted to better understand the impact of systemic cancer therapies on secondary malignancies.
目的
报告两例新病例，并总结一例在使用布鲁顿酪氨酸激酶抑制剂治疗血液系统恶性肿瘤后发生葡萄膜黑色素瘤的病例。
观察结果
一名71岁男性，有接受抗CD20抗体和布鲁顿酪氨酸激酶抑制剂治疗的华氏巨球蛋白血症病史，被诊断为脉络膜黑色素瘤伴眼内转移。一名73岁女性，有接受烷化剂化疗和抗CD20抗体治疗的套细胞淋巴瘤病史，复发后接受布鲁顿酪氨酸激酶抑制剂治疗，被诊断为葡萄膜黑色素瘤。
结论与意义
接受布鲁顿酪氨酸激酶抑制剂治疗的患者发生葡萄膜黑色素瘤的风险可能更高。基于我们的研究结果，我们建议加强对该患者群体继发性原发性或转移性葡萄膜黑色素瘤的监测。有必要持续记录其发生情况，并结合分子和细胞水平的研究，以更好地了解全身癌症治疗对继发性恶性肿瘤的影响。
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