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病理报告脾边缘带B细胞淋巴瘤
就诊医院杜克医院
目前状态康复5-10年
最后登录2022-9-27
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发表于 2019-8-31 03:34:22
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来自: 美国
有文献报道停过依布再用无效,医生并不太了解这个情况.
-------------------这个说法不是很准确。看看下面的例子。
A 65-Year-Old Man With Advanced Nodal MZL
November 2014
History & Physical:
A 65-year-old man presented with multiple lumps in groin, no pain
PMH: negative for HCV, HBV, HIV
PE: marked swelling in right axillary and bilateral inguinal lymph nodes
ECOG performance status: 0
Otherwise healthy, no history of CV disease or diabetes, weight within normal range
CT revealed lymphadenopathy at multiple nodal sites with multiple involved nodes (each <2 cm) involved at each site; no extranodal involvement or bulky disease
Biopsies confirmed presence of B cell infiltrate
IHC: B cell phenotype CD20, CD19
Treatment History:
He was started on active monitoring with CT, histology, and pathology every 6 mo.
November 2015
At 12 months following diagnosis, disease progression was shown on imaging, with additional involved axillary nodes
The patient was started on treatment with bendamustine/rituximab (BR)
November 2017
Follow-up imaging at 2 years following initiation of BR revealed disease progression in multiple lymph nodes at several sites
2 nodes measuring >3.0 cm
The patient was started on R-CHOP; he achieved a partial response
June 2018
7 months later, the patient developed relapsed disease
He was started on treatment with ibrutinib 560 mg/day orally
He developed mild diarrhea (managed with OTC anti-diarrheal) and bruising on legs from minor bumps
Follow-up CBC showed grade 3 neutropenia without fever
Ibrutinib was discontinued until neutrophils recovered and restarted at same dose without incident。
注意最后一句话。 |
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