ISSN (print) 1997-6933     ISSN (online) 2500-2139
Том 18 № 2 (2025), КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ
Том 18 № 2 (2025)
КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ

Ингибиторы тирозинкиназы Брутона в лечении рецидивов мантийноклеточной лимфомы с поражением ЦНС (два клинических наблюдения и обзор литературы)

Опубликовано 01.04.2025
Евгений Олегович Куневич
ГБУЗ «Ленинградская областная клиническая больница», пр-т Луначарского, д. 45, корп. 2А, Санкт-Петербург, Российская Федерация, 194291
https://orcid.org/0000-0002-1706-6642
Н.Н. Немсцверидзе
ФГБУ «Российский НИИ гематологии и трансфузиологии ФМБА России», ул. 2-я Советская, д. 16, Санкт-Петербург, Российская Федерация, 191024
https://orcid.org/0000-0002-3114-5902
М.А. Михалева
ФГБУ «Российский НИИ гематологии и трансфузиологии ФМБА России», ул. 2-я Советская, д. 16, Санкт-Петербург, Российская Федерация, 191024
https://orcid.org/0000-0002-2135-2051
А.Ю. Кувшинов
ФГБУ «Российский НИИ гематологии и трансфузиологии ФМБА России», ул. 2-я Советская, д. 16, Санкт-Петербург, Российская Федерация, 191024
https://orcid.org/0000-0002-0381-9041
Т.В. Овчинникова
ФГБУ «Российский НИИ гематологии и трансфузиологии ФМБА России», ул. 2-я Советская, д. 16, Санкт-Петербург, Российская Федерация, 191024
https://orcid.org/0009-0006-8129-3133
Е.В. Корякина
ГБУЗ «Городская больница № 15», ул. Авангардная, д. 4, корп. 1, Санкт-Петербург, Российская Федерация, 198205
С.В. Самарина
ФГБУН «Кировский НИИ гематологии и переливания крови ФМБА», ул. Красноармейская, д. 72, Киров, Российская Федерация, 610027
https://orcid.org/0000-0001-8639-719X
К.Ю. Крутикова
ООО «ЛАХТА клиника», ул. Дибуновская, д. 50А, Санкт-Петербург, Российская Федерация, 197183
С.В. Сидоркевич
ФГБУ «Российский НИИ гематологии и трансфузиологии ФМБА России», ул. 2-я Советская, д. 16, Санкт-Петербург, Российская Федерация, 191024
https://orcid.org/0000-0001-9931-9406
С.В. Волошин
ГБУЗ «Ленинградская областная клиническая больница», пр-т Луначарского, д. 45, корп. 2А, Санкт-Петербург, Российская Федерация, 194291; ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России, ул. Академика Лебедева, д. 6, Санкт-Петербург, Российская Федерация, 194044
https://orcid.org/0000-0003-1784-0375
2025-2
PDF_2025-18-2-184-196

Ключевые слова

мантийноклеточная лимфома
рецидивы с вовлечением ЦНС
ингибиторы тирозинкиназы Брутона
гематоэнцефалический барьер

Как цитировать

Куневич Е.О., Немсцверидзе Н.Н., Михалева М.А., Кувшинов А.Ю., Овчинникова Т.В., Корякина Е.В., Самарина С.В., Крутикова К.Ю., Сидоркевич С.В., Волошин С.В. Ингибиторы тирозинкиназы Брутона в лечении рецидивов мантийноклеточной лимфомы с поражением ЦНС (два клинических наблюдения и обзор литературы). Клиническая онкогематология. 2025;(2):184–196. doi:10.21320/2500-2139-2025-18-2-184-196.
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Статистика

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Ключевые слова

Аннотация

Мантийноклеточная лимфома (МКЛ) составляет 3–10 % всех вариантов неходжкинских лимфом и характеризуется агрессивным течением с частыми рецидивами и наличием экстранодальных поражений. В связи с появлением более эффективной системной противоопухолевой терапии и, как следствие, повышением продолжительности жизни пациентов частота рецидивов МКЛ с поражением ЦНС, по данным литературы, увеличилась до 4–20 %. Несмотря на широкое внедрение в клиническую практику таргетных препаратов, прогноз у пациентов с поражением ЦНС остается крайне неудовлетворительным. В качестве основной идеи в настоящей публикации выступает целесообразность применения при рецидивах МКЛ с поражением ЦНС препаратов из группы ингибиторов тирозинкиназы Брутона (BTK). Наиболее часто рекомендуется ибрутиниб как лекарственное средство, преодолевающее гематоэнцефалический барьер и обладающее высокой противоопухолевой активностью. Собственный опыт применения ибрутиниба при нейрорецидивах МКЛ представлен двумя клиническими наблюдениями. Одновременно широкому анализу подвергнуты соответствующие данные из литературы. Кроме того, в настоящем исследовании использовались данные 67 пациентов с МКЛ, которые получали лечение в гематологических стационарах различных медицинских учреждений Санкт-Петербурга и Ленинградской области с 2006 по 2023 г. Отчеты по двум клиническим наблюдениям составлены с учетом международных рекомендаций 2017 г. (CARE guidelines for case reports).

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