Lenalidomide combined with R-GDP in a patient with refractory CD5-positive diffuse large B-cell lymphoma: A promising response and review
Lenalidomide combined with R-GDP in a patient with refractory CD5-positive diffuse large B-cell lymphoma: A promising response and review
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来那度胺联合 R-GDP 治疗难治性 CD5 阳性弥漫性大 B 细胞淋巴瘤患者：有希望的疗效和综述
DOI：
10.1080/15384047.2018.1449609
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发表时间：
2018-04
影响因子：
3.6
通讯作者：
Huang Hongming
中科院分区：
文献类型：
--
作者：
Zhang Yaping;Wang Xinfeng;Liu Yifei;Sun Chunfeng;Shi Wenyu;Huang Hongming
与CD 5阴性的弥漫性大B细胞淋巴瘤相比，CD 5阳性（CD 5+）弥漫性大B细胞淋巴瘤（DLBCL）的生存率较低。CD 5 + DLBCL的临床特征不同于CD 5阴性DLBCL和其他CD 5 + B细胞淋巴瘤。目前尚无治疗CD 5 + DLBCL的有效化疗方案。在此，我们报告一位49岁的亚洲男性，患有难治性CD 5 + DLBCL。他主诉腹痛加重和体重减轻。电脑断层扫描显示腹部肿块，广泛淋巴结肿大，脾肿大，回盲部肠套叠伴肠壁增厚。腹部肿块的核心针吸活检和免疫组化显示非子宫中心型DLBCL。在本报告中，引入了剂量强化的R-Hyper CVAD（A）方案作为挽救治疗，但与最初的标准R-CHOP方案相比未能产生实质性改善。接下来，R-GDP方案作为二线治疗给药，但仅产生部分缓解。然而，在R-GDP（R2-GDP）中加入来那度胺导致完全缓解。文献中描述了来那度胺治疗CD 5 + DLBCL的临床特征、发病机制和可能的作用机制。本病例报告和文献检索的结果表明，通过基因表达谱确定，CD 5 + DLBCL可能与活化B细胞样（ABC）DLBCL具有共同的通路。预计来那度胺可在CD 5 + DLBCL患者中诱导有利的缓解。
ABSTRACT CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) is associated with poor survival compared with CD5-negative DLBCL. The clinical characteristics of CD5+ DLBCL are different from both CD5-negative DLBCL and other CD5+ B cell lymphomas. There is currently no promising chemotherapy for CD5+ DLBCL. Herein, we report a 49-year-old Asian male with refractory CD5+ DLBCL. He complained of aggravated abdominal pain and weight loss. Computed tomography scan revealed abdominal masses, widespread lymphadenopathy, splenomegaly, and intussusception of the ileocecal junction with bowel wall thickening. Core needle aspiration biopsy of an abdominal mass was performed and immunohistochemistry revealed DLBCL of nongerminal center type. In this report, the dose-intensified R-Hyper CVAD (A) regimen as salvage therapy was introduced but failed to result in substantial improvement over the initially standard R-CHOP regimen. Next, the R-GDP regimen was administered as second-line treatment, but only resulted in a partial response. However, the addition of lenalidomide to R-GDP (R2-GDP) resulted in complete remission. The clinical features, pathogenesis, and possible mechanism of action of lenalidomide in CD5+ DLBCL have been described in the literature. The results of the present case report and literature searches indicate that CD5+ DLBCL may share a common pathway with activated B-cell like (ABC) DLBCL as determined by gene expression profiling. Lenalidomide is expected to induce favorable responses in patients with CD5+ DLBCL.
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影响因子：
11.5
作者：
Wu, Lei;Adams, Mary;Bartlett, J. Blake
通讯作者：
Bartlett, J. Blake
影响因子：
78.5
作者：
通讯作者：
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影响因子：
6.5
作者：
Zhang, Ling-Hua;Kosek, Jolanta;Chopra, Rajesh
通讯作者：
Chopra, Rajesh
影响因子：
6.2
作者：
通讯作者：
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影响因子：
6.2
作者：
通讯作者：
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