塞利尼索联合化疗在复发/难治浆母细胞淋巴瘤的临床探索

Selinexor-based chemotherapy in the treatment of two patients with relapsed/refractory plasmablastic lymphoma

浆母细胞淋巴瘤(PBL)是一种罕见的侵袭性非霍奇金淋巴瘤,其预后不容乐观,总生存期较短,目前尚无标准的治疗方法。塞利尼索是全球首款选择性核输出蛋白抑制剂,它选择性地结合核输出蛋白1,促使癌细胞周期阻滞和凋亡。塞利尼索是一种很有前途的癌症治疗方法,目前已被批准用于治疗多发性骨髓瘤和弥漫大B细胞淋巴瘤。本文结合具体的病例,探讨塞利尼索改善PBL治疗现状的可能。2例年轻、既往接受过多线化疗及放疗的PBL患者,其中1例应用塞利尼索联合GDP方案获得非常好的部分缓解,另外1例急性肾衰竭、已无化疗指征的患者,应用塞利尼索联合GDP方案后肾功能逐渐恢复正常。表明塞利尼索可能为PBL患者带来临床获益,有待积累更多病例验证疗效。

Plasmablastic lymphoma(PBL) is an uncommon and aggressive type of non-Hodgkin lymphoma. Its prognosis remains dismal with short overall survival and currently, there is no standard therapy for this entity. Selinexor is a first-in-class, novel selective nuclear export inhibitor that selectively binds to export protein 1, leading to cell cycle arrest and apoptosis. Selinexor represents a promising therapy in cancer treatment and has been approved for treating multiple myeloma and diffuse large B-cell lymphoma. Combined with specific cases, this paper discusses the possibility of selinexor to improve the current situation of PBL treatment. There were two young patients with PBL who had received multiple prior lines of chemotherapy and radiotherapy. One patient obtained a very good partial response with selinexor in combination with the GDP regimen, and the other patient with acute renal failure and no indication for chemotherapy experienced renal function recovery through the same regimen. It indicates that selinexor may bring clinical benefits to PBL patients, and more cases are needed to verify the efficacy.