摘要
目的探讨晚期蕈样肉芽肿伴大细胞转化的临床特点及诊断和治疗。方法报告1例晚期蕈样肉芽肿伴大细胞转化病人,结合相关文献复习,总结其临床特点及诊治经验。结果病人给予CHOPE方案(环磷酰胺+脂质体多柔比星+长春新碱+泼尼松片+依托泊苷)化疗、西达本胺、苯达莫司汀、干扰素联合维A酸等治疗,效果均不佳,病情不断进展,周身皮肤淋巴隆起水肿、瘙痒难忍。给予CD30单抗(安适利)+GDP(吉西他滨、顺铂、氟美松)+PD-1方案再次化疗,4疗程后效果明显。结论蕈样肉芽肿伴大细胞转化诊治具有一定难度,在传统方法治疗效果不佳时,新药的使用或许是一种可行的甚至更好的方法。
Objective To investigate the clinical features,diagnosis,and treatment of advanced granuloma fungoides with large cell transformation.Methods This article reported a case of advanced granuloma fungoides with large cell transformation and summarized its clinical features and diagnosis and treatment experience based on a literature review.Results The patient received chemotherapy with the regimen of cyclophosphamide,liposomal doxorubicin,vincristine,prednisone tablets,and etoposide and was treated with chidamide,bendamustine,and interferon combined with acitretin.The patient had poor response and experienced continuous disease progression,with swelling and edema of skin and lymph nodes and unbearable pruritus.The patient was then given chemotherapy with the regimen of CD30 monoclonal antibody(Adcetris)+GDP(gemcitabine,cisplatin,and dexamethasone)+PD-1,which showed a marked clinical effect after four courses of treatment.Conclusion There are certain difficulties in the diagnosis and treatment of granuloma fungoides with large cell transformation,and when patients have poor response to conventional treatment methods,the use of new drugs may be a feasible and even better method.
作者
曹正
武智敏
赵新东
顾华丽
宋峤
吴少玲
CAO Zheng;WU Zhimin;ZHAO Xindong;GU Huali;SONG Qiao;WU Shaoling(Department of Medicine of Qingdao Univer-sity,Qingdao 266071,China)
出处
《青岛大学学报（医学版）》
CAS
2022年第4期625-627,共3页
Journal of Qingdao University(Medical Sciences)
基金
山东省自然科学基金资助项目(ZR2019MH096)。
