摘要
报道1例多发性骨髓瘤(MM)缓解期并发中枢神经系统(CNS)侵犯病例。患者中年女性,确诊MM予PCD方案(硼替佐米+环磷酰胺+地塞米松)4个疗程化疗后达完全缓解,巩固1个疗程,拟行造血干细胞移植,突发神经系统症状,完善MRI、流式细胞学等检查,明确诊断为MM并发CNS浸润,积极给予全身化疗+鞘内注射等治疗,再次达完全缓解后病情迅速恶化,颅内多发转移,家属放弃治疗,出院后持续口服伊布替尼,3个月后死亡。本文通过对国内外相关文献复习,对此病发生率、临床特征、诊断、治疗及预后等详细阐述,发现CNS侵犯MM较罕见且进展迅猛;回顾总结并分析本患者治疗过程,提示伊布替尼单药是此类患者可供选择的治疗方案。
One case of multiple myeloma(MM)with central nervous system(CNS)infiltration in remission stage is reported.The patient is a middle-aged female,who is diagnosed with MM and received PCD regimen(Bortezomib+Cyclophosphamide+Dexamethasone)for four courses of chemotherapy,and achieved complete remission.Consolidate one course of treatment,plan to carry out hematopoietic stem cell transplantation,sudden neurological symptoms,improve MRI,flow cytometry and other examinations,clearly diagnose MM complicated with CNS infiltration,and actively give systemic chemotherapy+intrathecal injection and other treatment.After reaching complete remission again,the condition deteriorated rapidly,multiple intracranial metastases,family members gave up treatment,continued to take Ibutinib orally after discharge,and died three months later.Based on the review of relevant literature at home and abroad,this paper expounds the incidence,clinical characteristics,diagnosis,treatment,and prognosis of this disease in detail.It is found that CNS invasion of MM is rare and progresses rapidly.The review,summary,and analysis of the treatment process of this patient shows that ibutinib single drug is an alternative treatment for this kind of patients.
作者
安万花
王万里
郭淑利
王松云
王慧睿
AN Wanhua;WANG Wanli;GUO Shuli;WANG Songyun;WANG Huirui(Department of Hematology Medicine,Luoyang Central Hospital Affiliated to Zhengzhou University,Henan Province,Luoyang 471009,China)
出处
《中国医药导报》
CAS
2022年第20期185-188,共4页
China Medical Herald
基金
河南省重点研发与推广专项(202102310379)
河南省洛阳市科技计划项目(2101026A)。
关键词
多发性骨髓瘤
缓解期中枢神经系统浸润
脑脊液
流式细胞学
预后
Multiple myeloma
Central nervous system infiltration in remission stage
Cerebrospinal fluid
Flowcytometry
Prognosis
