BTK抑制剂在中枢神经系统淋巴瘤中的治疗作用及安全性分析

Efficacy and safety of BTK inhibitors in the treatment of central nervous system lymphoma

    摘要
  • 摘要:
      目的  研究布鲁顿酪氨酸激酶（Bruton's tyrosine kinase，BTK）抑制剂治疗复发/难治性中枢神经系统淋巴瘤(relapsed/refractory central nervous system lymphoma，R/R CNSL）的有效性和安全性。
      方法  回顾性分析郑州大学第一附属医院2018年10月至2021年10月收治的43例R/R CNSL患者，分别使用BTK抑制剂单药、BTK抑制剂联合化疗、BTK抑制剂联合免疫治疗方案，BTK抑制剂包括伊布替尼、泽布替尼、奥布替尼，初始剂量分别为（420～560）mg/d、320 mg/d、（100～150）mg/d，分析治疗后的最好疗效和不良反应。
      结果  BTK抑制剂单药组（A组）、BTK抑制剂联合化疗组（B组）、BTK抑制剂联合免疫治疗组（C组）的客观缓解率（objective response rate，ORR）分别为44.4%、85.7%和76.9%，B组的ORR高于A、C组，原发中枢神经系统淋巴瘤（primary CNSL，PCNSL）患者的ORR（78.6% vs. 66.7%）高于继发中枢神经系统淋巴瘤（secondary CNSL，SCNSL）患者，两者的无进展生存期（progression-free survival，PFS）和总生存期（overall survival，OS）差异均无统计学意义（均P>0.05）。3/4级不良反应主要为白细胞减少、血小板减少、贫血。贫血。
      结论  BTK抑制剂单药及联合方案对R/R CNSL患者疗效可，不良反应可耐受。

     

    Abstract:
      Objective  To investigate the efficacy and safety of Bruton's tyrosine kinase (BTK) inhibitors in the treatment of relapsed/refractory central nervous system lymphoma (R/R CNSL).
      Methods  A retrospective analysis of 43 patients with R/R CNSL admitted to The First Affiliated Hospital of Zhengzhou University from October 2018 to October 2021, who were treated with BTK inhibitor monotherapy (group A), BTK inhibitor combined with chemotherapy (group B), or BTK inhibitor combined with immunotherapy regimens (group C) was conducted. BTK inhibitors included ibrutinib, zanubrutinib, and obrutinib, with initial doses of (420–560) mg/day, 320 mg/day, and (100–150) mg/day, respectively. After treatment, the efficacy and adverse reactions were analyzed.
      Results  The objective response rate (ORR) of groups A, B, and C were 44.4%, 85.7%, and 76.9%, respectively. The ORR of group B was higher than that of groups A and C. Patients with primary central nervous system lymphoma (PCNSL) had a higher ORR (78.6% vs. 66.7%) than patients with secondary central nervous system lymphoma (SCNSL). Progression-free survival (PFS) (P=0.67) and overall survival (OS) (P=0.77) were not significantly different between patients with PCNSL and SCNSL. Grade 3/4 adverse reactions were mainly leukopenia, thrombocytopenia, and anemia.
      Conclusions  The efficacy of BTK inhibitors as single drugs and combined regimens for patients with R/R CNSL is acceptable, and the adverse reactions are tolerable.

     

    • HTML全文
    • 参考文献(23)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回