| 宋玉臻,王椋,梁智皓,等.利妥昔单抗联合奥布替尼治疗变异型毛细胞白血病 1例[J].安徽医药,2025,29(3):629-633. |
| 利妥昔单抗联合奥布替尼治疗变异型毛细胞白血病 1例 |
| A case report: rituximab combined with orelabrutinib in the treatment of variant hairy cell leukemia |
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| DOI：10.3969/j.issn.1009-6469.2025.03.041 |
| 中文关键词: 白血病，多毛细胞 变异 白细胞分化抗原 利妥昔单抗 奥布替尼 |
| 英文关键词: Leukemia, hairy cell Variation Eukocyte differentiation antigen Rituximab Obutinib |
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| 中文摘要: |
| 目的探讨变异型毛细胞白血病( HCL-V)的诊断、临床表现及治疗方案。方法回顾性分析胜利油田中心医院 2021年 11月 14日收治的 1例 HCL-V病人的临床资料，并复习相关文献。结果病人为 71岁男性，伴有脾大及淋巴结肿大，根据骨髓形态、免疫学分型、免疫组织化学及分子生物学特点，符合 HCL-V的诊断。病人应用 1疗程利妥昔单抗联合克拉屈滨化疗方案后，脾脏明显缩小，但疗效评价为疾病稳定。后改用利妥昔单抗联合奥布替尼化疗方案 5疗程，尽管疗效评价为部分缓解，但已接近完全缓解。至截稿前正在治疗中。结论 HCL-V临床罕见，可结合骨髓形态、免疫学分型、免疫组织化学及分子生物学特点作出诊断，目前尚无标准治疗方案。奥布替尼对布鲁顿型酪氨酸激酶以外的靶点作用极低。利妥昔单抗联合奥布替尼化疗在 HCL-V病人的治疗中取得了良好的疗效，但远期疗效还需观察。 |
| 英文摘要: |
| Objective To investigate the diagnosis, clinical manifestations and treatments of variant hairy cell leukemia (HCL-V). Methods The clinical data of 1 case of HCL-V in Shengli Oilfield Central Hospital on November 14, 2021 were retrospectively ana-lyzed, and the related literatures were reviewed.Results The patient was a 71-year-old male with splenomegaly and lymphadenecta-sis. According to the characteristics of bone marrow morphology, immunological classification, immunohistochemical and molecular bi-ology, the patient conformed to the diagnosis of HCL-V. After one course of rituximab combined with cladribine chemotherapy, thespleen was significantly reduced, but the therapeutic evaluation was stable disease. Then rituximab combined with orelabrutinib chemo-therapy was used for 5 courses. Although the efficacy evaluation was partial response, it was close to complete response. He was undertreatment by the submission of this paper.Conclusions HCL-V is rare in clinic, and its diagnosis should be combined with bone mar-row morphology, immunotype, immunohistochemical and molecular biological characteristics. There is no standard treatment. Obutinibhas very little effect on targets other than Bruton-type tyrosine kinases. Rituximab combined with aubutinib chemotherapy has achieved good efficacy in the treatment of HCL-V patients, but the long-term curative effect remains to be observed. |
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