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原发性中枢神经系统淋巴瘤管理中的挑战

英文原题:Challenges in the management of primary central nervous system lymphoma.

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Challenges in the management of primary central nervous system lymphoma.

PubMed 2023/06/03(内容时间) Crit Rev Oncol Hematol Q1 · IF 6.2(JCR 2025)

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中文摘要

原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的结外非霍奇金淋巴瘤。立体定向活检仍是 PCNSL 病理诊断的金标准。然而,某些新的辅助诊断方法被认为具有良好的应用前景,包括细胞因子和肿瘤循环 DNA 等。尽管免疫调节剂、免疫检查点抑制剂、CAR-T 细胞和布鲁顿酪氨酸激酶抑制剂等新药因其疗效改善而带来了希望,但高复发率和随之而来的高死亡率仍是长期生存的障碍。因此,巩固治疗越来越受到重视。巩固治疗策略包括全脑放疗、自体造血干细胞移植和非清髓性化疗。由于缺乏直接比较不同巩固治疗方案有效性和安全性的研究,最佳巩固策略仍不确定。本文将综述 PCNSL 的诊断和治疗,重点介绍巩固治疗相关研究进展。

展开英文摘要原文

Primary central nervous system lymphoma (PCNSL) is a rare extranodal non-Hodgkin lymphoma. Stereotactic biopsy remains the gold standard for the pathological diagnosis of PCNSL.

However, certain new auxiliary diagnostic methods are considered to have good application prospects; these include cytokine and tumor circulating DNA, among others. Although new drugs such as immunomodulators, immune checkpoint inhibitors, chimeric antigen receptor T-cells, and Bruton tyrosine kinase inhibitors have brought hope owing to their improved efficacy, the high recurrence rate and subsequent high mortality remain barriers to long-term survival. Increasing emphasis is therefore being placed on consolidation treatments.

Consolidation treatment strategies include whole brain radiotherapy, autologous hematopoietic stem cell transplantation, and non-myeloablative chemotherapy. As studies directly comparing the effectiveness and safety of different consolidation treatment schemes are lacking, the optimal consolidation strategy remains uncertain. This article will review the diagnosis and treatment of PCNSL, focusing on the progress in research pertaining to consolidation therapy.

论文信息

作者
Sun X、Lv L、Wu Y、Cui Q、Sun S、Ji N、Liu Y
第一作者单位
Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.China
通讯作者单位
Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: yuanbol@ccmu.edu.cn.China
文献类型
综述
期刊
Critical reviews in oncology/hematology2023 Aug
原文标识
PubMed 37277008 · DOI 10.1016/j.critrevonc.2023.104042