Selinexor combined with PD-1 monoclonal antibody in the treatment of relapsed/refractory primary central nervous system lymphoma: a case report
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摘要: 为探索复发难治性原发中枢神经系统淋巴瘤(R/R PCNSL)的挽救治疗方案，并为改善该类患者的生存预后提供参考，现回顾1例R/R PCNSL患者的临床病理资料及诊治经过。患者，女，44岁，于外院明确诊断为原发中枢神经系统弥漫大B细胞淋巴瘤非生发中心细胞来源。经多线治疗，疾病未能有效缓解，呈现多药耐药，给予“塞利尼索联合PD-1单抗”挽救治疗，3个周期后达未确定的完全缓解，共接受该方案6个周期，获得无进展生存6个月余。
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关键词:
- 原发中枢神经系统淋巴瘤 /
- 弥漫大B细胞淋巴瘤 /
- 塞利尼索 /
- XPO1
Abstract: In order to explore the salvage treatment regimen of relapsed/refractory primary central nervous system lymphoma(R/R PCNSL), and provide a reference for improving the survival prognosis of such patients, the clinical pathological data and diagnosis and treatment of a patient with R/R PCNSL were reviewed. A 44-year-old female patient was definitely diagnosed with primary diffuse large B-cell lymphoma of the central nervous system of non-germinal center B cell like in another hospital. After multiple lines of treatment, the disease failed to alleviate effectively and presented with multidrug resistance. The salvage therapy was administrated with selinexor combined with PD-1 monoclonal antibody, and undetermined complete remission was achieved after 3 cycles therapy. Finally, the patient received a total of 6 cycles of this regimen and achieved progression-free survival for more than 6 months. -
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表 1 患者淋巴瘤相关93基因测序结果
基因名称 碱基改变 突变频率/% CDKN2A c.221dupA 20.3 CARD11 c.1876G>A 19.4 B2M c.20T>Gp.L7 32.9 MLL c.3629C>T 52.4 CARD11 c.2081C>T 49.2 PCLO c.1531C>T 47.9 MEF2B c.247G>A 17.2 CARD11 c.1081T>A 17.1 CCND2 c.841C>T 16.0 CARD11 c.704G>C 11.5 IGH-BCL6 基因重排 15.7 
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