Wang Wenwen, Chen Jianlin, Guan Lingsu
Department of Hematology, Taizhou Central Hospital, Taizhou, China.
Department of Gastrointestinal Surgery, Taizhou Central Hospital, Taizhou, China.
Front Immunol. 2025 Jun 26;16:1597119. doi: 10.3389/fimmu.2025.1597119. eCollection 2025.
We report a case of acute B-cell leukemia complicated by central nervous system (CNS) post-transplant lymphoproliferative disorder (PTLD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient achieved sustained disease stabilization following therapeutic dose modification of orelabrutinib, representing the first evidence-based documentation that Bruton's tyrosine kinase (BTK) inhibitor down-titration confers clinical efficacy in PTLD. Epstein-Barr virus (EBV)-associated PTLD is a serious complication following allogeneic HSCT, with frequent CNS involvement. Effective treatment for CNS involvement is often hampered by the challenge of drug penetration across the blood-brain barrier. This case highlights the potential benefit and safety of dose-adjusted orelabrutinib in controlling CNS PTLD, suggesting a promising therapeutic approach.
我们报告了一例异基因造血干细胞移植（allo-HSCT）后并发中枢神经系统（CNS）移植后淋巴细胞增殖性疾病（PTLD）的急性B细胞白血病病例。在对奥布替尼进行治疗剂量调整后，患者实现了疾病的持续稳定，这是首个基于证据的文献证明布鲁顿酪氨酸激酶（BTK）抑制剂减量在PTLD中具有临床疗效。爱泼斯坦-巴尔病毒（EBV）相关的PTLD是异基因HSCT后的一种严重并发症，常累及中枢神经系统。药物透过血脑屏障的挑战常常阻碍对中枢神经系统受累的有效治疗。该病例突出了剂量调整后的奥布替尼在控制中枢神经系统PTLD方面的潜在益处和安全性，提示了一种有前景的治疗方法。
