Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report
Abstract Background Despite increasing effort for treating primary central nervous system lymphoma (PCNSL), the prognosis of human immunodeficiency virus (HIV) -related PCNSL was still unsatisfactory. There is currently a lack of clinical evidence for the application of Bruton tyrosine kinase (BTK)...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | AIDS Research and Therapy |
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| Online Access: | https://doi.org/10.1186/s12981-023-00554-8 |
| _version_ | 1797556288556630016 |
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| author | Ying Zhou Xiaoxue Wang Xuyong Lin Jun Wang Xiaojing Yan Ying Wen |
| author_facet | Ying Zhou Xiaoxue Wang Xuyong Lin Jun Wang Xiaojing Yan Ying Wen |
| author_sort | Ying Zhou |
| collection | DOAJ |
| description | Abstract Background Despite increasing effort for treating primary central nervous system lymphoma (PCNSL), the prognosis of human immunodeficiency virus (HIV) -related PCNSL was still unsatisfactory. There is currently a lack of clinical evidence for the application of Bruton tyrosine kinase (BTK) inhibitor in HIV-related PCNSL. We reported two HIV-related PCNSL patients, who achieved sustained remission by application of BTK inhibitor based treatment. This protocol had not been previously reported for the treatment of HIV-related PCNSL. Case presentation The two cases were characterized by the treatment choice of Bruton tyrosine kinase (BTK) inhibitor. Rituximab was not recommended for them due to their very low CD4+ T cell counts. They both took MTX as the first-line therapy and got a relief in initial phase. For the first case, ibrutinib was kept both in the first-line therapy and in the maintenance therapy. When the second case underwent a progressive disease, we continued to use orelabrutinib as one of the salvage treatment, in combination with programmed cell death-1 (PD-1) inhibitor plus lenalidomide. They both achieved a continuous response of up to 20 months without opportunistic infection. Conclusions This report highlights the safety and effectiveness of BTK inhibitors, as well as lenalidomide and PD-1 inhibitor in HIV-related PCNSL patients. Both the new therapeutic approaches and a multidisciplinary team authentically contributed to improved survival outcome among HIV-positive PCNSL patients. |
| first_indexed | 2024-03-10T17:00:41Z |
| format | Article |
| id | doaj.art-40a30e66ce484da790091052d8194380 |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-03-10T17:00:41Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-40a30e66ce484da790091052d81943802023-11-20T10:59:03ZengBMCAIDS Research and Therapy1742-64052023-08-012011510.1186/s12981-023-00554-8Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case reportYing Zhou0Xiaoxue Wang1Xuyong Lin2Jun Wang3Xiaojing Yan4Ying Wen5Department of Infectious Diseases II, The First Affiliated Hospital of China Medical UniversityDepartment of hematology, The First Affiliated Hospital of China Medical UniversityDepartment of pathology, The First Affiliated Hospital of China Medical UniversityDepartment of neurosurgery, The First Affiliated Hospital of China Medical UniversityDepartment of hematology, The First Affiliated Hospital of China Medical UniversityDepartment of Infectious Diseases II, The First Affiliated Hospital of China Medical UniversityAbstract Background Despite increasing effort for treating primary central nervous system lymphoma (PCNSL), the prognosis of human immunodeficiency virus (HIV) -related PCNSL was still unsatisfactory. There is currently a lack of clinical evidence for the application of Bruton tyrosine kinase (BTK) inhibitor in HIV-related PCNSL. We reported two HIV-related PCNSL patients, who achieved sustained remission by application of BTK inhibitor based treatment. This protocol had not been previously reported for the treatment of HIV-related PCNSL. Case presentation The two cases were characterized by the treatment choice of Bruton tyrosine kinase (BTK) inhibitor. Rituximab was not recommended for them due to their very low CD4+ T cell counts. They both took MTX as the first-line therapy and got a relief in initial phase. For the first case, ibrutinib was kept both in the first-line therapy and in the maintenance therapy. When the second case underwent a progressive disease, we continued to use orelabrutinib as one of the salvage treatment, in combination with programmed cell death-1 (PD-1) inhibitor plus lenalidomide. They both achieved a continuous response of up to 20 months without opportunistic infection. Conclusions This report highlights the safety and effectiveness of BTK inhibitors, as well as lenalidomide and PD-1 inhibitor in HIV-related PCNSL patients. Both the new therapeutic approaches and a multidisciplinary team authentically contributed to improved survival outcome among HIV-positive PCNSL patients.https://doi.org/10.1186/s12981-023-00554-8Primary central nervous system lymphomaHuman immunodeficiency virusBruton tyrosine kinase inhibitor |
| spellingShingle | Ying Zhou Xiaoxue Wang Xuyong Lin Jun Wang Xiaojing Yan Ying Wen Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report AIDS Research and Therapy Primary central nervous system lymphoma Human immunodeficiency virus Bruton tyrosine kinase inhibitor |
| title | Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report |
| title_full | Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report |
| title_fullStr | Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report |
| title_full_unstemmed | Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report |
| title_short | Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report |
| title_sort | sustained response following btk inhibitors based treatment in hiv related primary central nervous system lymphoma case report |
| topic | Primary central nervous system lymphoma Human immunodeficiency virus Bruton tyrosine kinase inhibitor |
| url | https://doi.org/10.1186/s12981-023-00554-8 |
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