R2联合奥布替尼治疗高龄初诊弥漫大B细胞淋巴瘤1例并文献复习

A Case of R2 Combined with Orelabrutinib in the Treatment of Newly Diagnosed Diffuse Large B-Cell Lymphoma in the Elderly and Literature Review

摘要: 患者，女，85岁，该患者初诊断为非生发中心型(non-GCB型)弥漫大B细胞淋巴瘤(Diffuse Large B-Cell Lymphoma, DLBCL) IV期A组，IPI 4分高危，KPS评分：40分，PS评分：3~4分，既往有冠心病史，免疫组化：CD20 (+)，Ki-67 (约80%+)，CD79a (+)，PAX5 (+)，CD19 (+)，BCL-2 (约85%中+)，BCL-6 (约25%中–弱+)，MUM-1 (约30%中–弱+)，C-myc (约20%中–弱+)，P53 (约85%中–强+)，CD15 (+)，CD30 (+)，CyclinD1 (−)，CD34 (灶+)，采用R2 (利妥昔单抗 + 来那度胺)联合奥布替尼方案治疗后颈部肿块明显缩小，疗效较满意。本文阐述高龄弥漫大B细胞淋巴瘤患者诊断经过、治疗方案及文献回顾。

Abstract: The patient, an 85-year-old female, was initially diagnosed with non-germinal center (non-GCB) diffuse large B-cell lymphoma stage IV group A, IPI score 4, high-risk, KPS score: 40 points, PS score: 3~4 points, previous history of coronary artery disease, immunohistochemistry: CD20 (+), Ki-67 (about 80%+), CD79a (+), PAX5 (+), CD19 (+), BCL-2 (about 85% medium+), BCL-6 (about 25% medium-weak+), MUM-1 (about 30% medium-weak+), C-myc (about 20% medium-weak+), P53 (about 85% medium-strong+), CD15 (+), CD30 (+), CyclinD1 (−), CD34 (foci+), R2 (rituximab + lenalidomide) combined with orelabrutinib regimen after treatment with neck lump significantly reduced, and the efficacy was satisfactory. This article describes the diagnosis, treatment regimen and literature review of elderly patients with diffuse large B-cell lymphoma.