摘要
原发性睾丸淋巴瘤（PTL）是一类少见的结外淋巴瘤,进展迅速,预后不良.对于早期局限性病变,可联合应用以蒽环类为基础的化疗、利妥昔单抗、鞘内注射甲氨蝶呤后行对侧睾丸放疗等.中枢神经系统复发风险极高,鞘内注射甲氨蝶呤可能是最好的防治方法.原发性中枢神经系统淋巴瘤（PCNSL）是一种侵袭性淋巴瘤,预后较差,对现有非霍奇金淋巴瘤标准治疗方案均不敏感,甲氨蝶呤联合阿糖胞苷是目前的标准诱导方案.抗CD20单克隆抗体虽然脑脊液含量低,但仍有治疗效果.高剂量化疗联合自体造血干细胞移植缓解率高,3年总生存率可达87％.
Primary testicular lymphoma （PTL） is an uncommon extranodal lymphoma,with an aggressive clinical course and poor outcome.A combined treatment with full-course anthracycline-based chemotherapy with rituximab and central nervous system prophylaxis with intrathechal methotrexate and contralateral testicular radiotherapy should be considered as the standard of care at limited stage.These patients have a very high risk of central nervous system recurrence and the addition of systemic central nervous system prophylaxis with intravenous methotrexate may be the best treatment option.Primary central nervous system lymphoma （PCNSL） is an aggressive disease with a dismal prognosis,particularly when treated with established protocols used for systemic non-Hodgkin lymphoma.Use of methotrexate in combination with cytarabine has been proposed as a standard induction regimen.The role of the anti-CD20 antibody has not yet been defined,however,phase Ⅰ and Ⅱ trials suggest its efficacy despite low penetration within the cerebrospinal fluid.High-dose chemotherapy followed by autologous stem cell transplantation has shown high remission rates with 3-year overall suvival rates of up to 87 %.
出处
《白血病．淋巴瘤》
CAS
2014年第10期586-588,592,共4页
Journal of Leukemia & Lymphoma
关键词
原发性睾丸淋巴瘤
原发性中枢神经系统淋巴瘤
欧洲血液学会年会
Primary testicular lymphoma
Primary central nervous system lymphoma
European Hematology Association annual congress
