奥妥珠单抗联合化疗治疗多线化疗后进展且塞利尼索无效的TP53突变Burkitt淋巴瘤

Obinutuzumab in combination with chemotherapy for TP53-mutated Burkitt lymphoma that progressed after multi-line chemotherapy and was selinexor-ineffective

Burkitt淋巴瘤是一种高度侵袭性的非霍奇金B细胞淋巴瘤(B-NHL),其特征为IGH/MYC基因易位及MYC蛋白高表达。多线化疗后进展且在使用小分子核输出蛋白1(XPO1)抑制剂塞利尼索后仍无效的TP53突变Burkitt淋巴瘤是目前的治疗难点,可选择的治疗方案十分有限,目前仍无有效治疗手段,且预后极差。本文报道伴TP53突变Burkitt淋巴瘤多线化疗后进展且塞利尼索治疗无效的患者2例。患者均接受奥妥珠单抗(G)联合二线方案治疗(1例G-DA-EPOCH方案、1例Ibru+GB方案),目前疗效评估均达到完全缓解(CR),主要不良反应为输液相关反应,经对症支持治疗后明显缓解。以奥妥珠单抗为代表的新药治疗可为目前多线化疗后进展且塞利尼索无效的TP53突变Burkitt淋巴瘤患者的治疗提供参考。

Burkitt lymphoma is a highly aggressive non-Hodgkin B-cell lymphoma characterized by IGH/MYC gene translocation and high expression of MYC protein.TP53-mutated Burkitt lymphoma that progresses after multi-line chemo-therapy and remains ineffective after the use of the small molecule nuclear export(XPO1)inhibitor selinexor is a current treatment challenge.The available treatment options are very limited.There is still no effective treatment,and the prognosis is extremely poor.Here we reported two patients with TP53-mutated Burkitt lymphoma who progressed after multi-line che-motherapy and failed to respond to selinexor.All patients were treated with obinutuzumab(G)combined with second-line regimen(1 case with G-DA-EPOCH regimen,1 case with Ibru+GB regimen).At present,the efficacy evaluation showed that all patients achieved complete permission(CR).The main adverse reactions were infusion-related reactions,which were obviously relieved after symptomatic and supportive treatment.The new drug therapy as ortuzumab can provide refer-ences for the treatment of patients with TP53-mutated Burkitt lymphoma who have progressed after multi-line chemothera-py and had no response to selinexor.