R-MAD方案治疗原发眼附属器双表达弥漫大B细胞淋巴瘤一例并文献复习

Primary ocular adnexal double-expression diffuse large B-cell lymphoma treated with R-MAD regimen:report of one case and review of literature

目的探讨R-MAD方案(利妥昔单抗、甲氨蝶呤、阿糖胞苷、地塞米松)治疗原发眼附属器双表达弥漫大B细胞淋巴瘤(DLBCL)患者的临床效果。方法回顾性分析福建医科大学附属协和医院2019年6月收治的1例接受R-MAD方案治疗的老年原发眼附属器双表达DLBCL患者的临床资料,分析其临床特点、诊治与预后情况,并进行文献复习。结果患者,男性,71岁,初始予经典R-CHOP方案化疗后,眼球肿物未见缩小,肿痛进一步加重,疗效欠佳,病情继续进展。随后予R-MAD方案化疗3个疗程,患者眼部肿胀消退,疼痛症状明显改善,获得较满意疗效,且未见明显不良反应。结论R-MAD方案治疗原发眼附属器双表达DLBCL患者效果良好,能明显改善症状,延缓病情进展,改善患者生命质量,但预后情况仍需长期随访。

Objective To explore the clinical effect of R-MAD(rituximab,methotrexate,cytarabine,dexamethasone)regimen in the treatment of primary ocular adnexal double-expression diffuse large B-cell lymphoma(DLBCL).Methods The clinical data of an elderly patient with primary ocular adnexal double-expression DLBCL who was treated with R-MAD regimen in June 2019 in Fujian Medical University Union Hospital was retrospectively analyzed.The clinical manifestations,diagnosis and treatment,prognosis were also analyzed,and the related literature was reviewed.Results The patients was a 71-year-old male.After initial treatment of R-CHOP chemotherapy,the patient's eye mass did not shrink,the swelling and pain became worse,the curative effect was not good,and the disease progression continued.After the patient was given R-MAD chemotherapy for 3 courses,the eye swelling subsided and pain symptoms were significantly improved,satisfactory results were obtained,and no obvious adverse reactions occurred.Conclusions R-MAD regimen has an ideal effect on the patient with primary ocular adnexal double-expression DLBCL,which can significantly improve symptoms,delay disease progression,and improve the quality of life of patients,but the prognosis still needs to be followed up in the long-term.