Blood:鼻型结外NK/T细胞淋巴瘤的治疗进展

2018-04-02 MedSci MedSci原创

鼻型结外NK/T细胞淋巴瘤(ENKL)是成熟T/NK淋巴细胞瘤的一种亚型,原发于鼻腔,特点是与Epstein-Barr(EB)病毒感染有关。亚洲及南美洲发病率高,西欧及北美地区少见,中年男性好发(男女比4:1)。无特异性临床表现。虽然ENKL的发病率存在地域差异,但西方国家和流行病区(如东亚)之间的临床特点相似。目前,不推荐用包含蒽环霉素的化疗方案治疗ENKL。尚无基于随机对照试验结果的标准治疗方

鼻型结外NK/T细胞淋巴瘤(ENKL)是成熟T/NK淋巴细胞瘤的一种亚型,原发于鼻腔,特点是与Epstein-Barr(EB)病毒感染有关。亚洲及南美洲发病率高,西欧及北美地区少见,中年男性好发(男女比4:1)。无特异性临床表现。

虽然ENKL的发病率存在地域差异,但西方国家和流行病区(如东亚)之间的临床特点相似。目前,不推荐用包含蒽环霉素的化疗方案治疗ENKL。尚无基于随机对照试验结果的标准治疗方案。

对于局限性疾病患者,放疗是推荐的一线疗法的核心部分。放疗剂量50-54Gy,根据肿瘤侵袭性扩大放疗范围、应用强度调制的放疗或容量调制的电弧治疗均与放疗的效果相关。

虽然联合放化疗得到临床试验结果的支持,但越来越多的证据支持采用无蒽环霉素的连续放化疗,包括L-天冬氨酰胺酶和(或)铂类抗癌药。包含L-天冬氨酰胺酶的化疗方案是全身性ENKL的一线治疗的核心。此外,推荐将造血干细胞移植作为新确诊的晚期ENKL的一线巩固治疗。包括免疫检查点抑制剂的新制剂正在研究用于治疗ENKL。

对于当下对ENKL的治疗,需要多学科的共同努力来确定应用放疗、L-天冬酰胺酶、铂、新制剂和造血干细胞移植的最佳的时间和顺序。

原始出处:

Motoko Yamaguchi, Ritsuro Suzuki, and Masahiko Oguchi. Advances in the treatment of extranodal NK/T-cell lymphoma, nasal type. Blood  2018  :blood-2017-12-791418;  doi: https://doi.org/10.1182/blood-2017-12-791418

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    2018-10-30 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 02 17:28:11 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-13 1222becem95暂无昵称

    学习了

    0

  5. 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  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 02 17:28:11 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 1e0f8808m18(暂无匿称)

    学习了.谢谢分享.

    0

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createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon Apr 02 18:15:53 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302086, encodeId=cb4e3020863f, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2emBzjO0FtqTJ05AqrEEdRmp6tmlsLXqpzfxWdtgbbgPGWRHagoK9fLTd3IayRPgkJVIVBWtdlmnkBhOIR4cFM/0, createdBy=e8d51649330, createdName=飘飘爱, createdTime=Mon Apr 02 18:02:05 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302078, encodeId=b00a3020e84c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 02 17:28:11 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 131****1460

    学习了受益匪浅

    0

  8. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 02 17:28:11 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

  9. 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createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon Apr 02 18:15:53 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302086, encodeId=cb4e3020863f, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2emBzjO0FtqTJ05AqrEEdRmp6tmlsLXqpzfxWdtgbbgPGWRHagoK9fLTd3IayRPgkJVIVBWtdlmnkBhOIR4cFM/0, createdBy=e8d51649330, createdName=飘飘爱, createdTime=Mon Apr 02 18:02:05 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302078, encodeId=b00a3020e84c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 02 17:28:11 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 飘飘爱

    很好

    0

  10. 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createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon Apr 02 18:15:53 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302086, encodeId=cb4e3020863f, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2emBzjO0FtqTJ05AqrEEdRmp6tmlsLXqpzfxWdtgbbgPGWRHagoK9fLTd3IayRPgkJVIVBWtdlmnkBhOIR4cFM/0, createdBy=e8d51649330, createdName=飘飘爱, createdTime=Mon Apr 02 18:02:05 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=302078, encodeId=b00a3020e84c, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Apr 02 17:28:11 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 虈亣靌

    学习了谢谢分享!!

    0