【摘要】 目的：探讨以利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合布鲁顿氏酪氨酸激酶（Bruton’s tyrosine kinase,BTK）抑制剂的方案治疗MCL患者的疗效和安全性，旨在改良套细胞淋巴瘤（mantle cell lymphoma,MCL）的治疗方案。方法：回顾性分析郑州大学第一附属医院2021年3月至2023年11月收治的26例初治MCL病例，采用利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合BTK抑制剂治疗方案的疗效和不良反应。结果：26例初治MCL患者中位年龄为59(41～72)岁，其中男性22例、女性4例，中位随访时间为12(3～28)个月。在26例患者中，总缓解率（overall response rate,ORR）为92.3%，完全缓解率（complete response rate,CRR）为88.5%。中位无进展生存期（progression-free survival,PFS）和中位总生存期（overall survival,OS）均未达到，1年PFS率为81.25%,1年OS率为92.3%。MCL国际预后指数（MIPI）评分0～3分组的PFS优于MIPI评分4～11分组（P=0.020），无B症状组的PFS优于有B症状组（P=0.002）,经典型组的PFS优于母细胞样/多形性变异组（P=0.009）。主要不良反应为淋巴细胞和血小板减少症，在随访期间未观察到与治疗相关的严重不良事件发生。结论：利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合BTK抑制剂的方案在初治MCL患者中治疗是安全有效的。更多还原

【Abstract】 Objective: To improve the therapeutic regimen for mantle cell lymphoma, we investigated the efficacy and safety of adding a BTK inhibitor to a regimen including rituximab, bendamustine, cytarabine, and prednisone to treat patients with mantle cell lymphoma(MCL).Methods: Twenty-six patients newly diagnosed with MCL who were admitted to The First Affiliated Hospital of Zhengzhou University from March 2021 to November 2023 were treated with a regimen of rituximab, bendamustine, cytarabine and prednisone combined with a BTK inhibitor, and the efficacy and adverse effects of this regiment were retrospectively analyzed. Results: The median age of the 26 newly diagnosed MCL patients was 59(41-72) years. The cohort included 22 males and 4 females, and the median follow-up time was 12(3-28)months. The overall response rate(ORR) was 92.3% and the complete response rate(CRR) was 88.5%. Median progression-free survival(PFS) and median overall survival(OS) endpoints were not achieved, with a 1-year PFS rate of 81.25% and a 1-year OS rate of 92.3%. A better PFS was achieved in the low mantle cell lymphoma International Prognostic Index(MIPI) score(0-3 points) group than in the high MIPI score(4-11 points) group(P=0.020). PFS was better in the group without B symptoms than in the group with B symptoms(P=0.002). PFS was better in the classical group than in the pleomorphic-blastoid subtype group(P=0.009). The main adverse effects were lymphopenia and thrombocytopenia. No treatment-related serious adverse events were observed during the follow-up period. Conclusions: The regimen of rituximab, bendamustine, cytarabine, and prednisone in combination with BTK inhibitors is safe and effective for the treatment of newly diagnosed patients with MCL.更多还原