Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report

Bibliographic Details
Title: Sustained response following BTK inhibitors based treatment in HIV-related primary central nervous system lymphoma: case report
Authors: Ying Zhou, Xiaoxue Wang, Xuyong Lin, Jun Wang, Xiaojing Yan, Ying Wen
Source: AIDS Research and Therapy, Vol 20, Iss 1, Pp 1-5 (2023)
Publisher Information: BMC, 2023.
Publication Year: 2023
Collection: LCC:Immunologic diseases. Allergy
Subject Terms: Primary central nervous system lymphoma, Human immunodeficiency virus, Bruton tyrosine kinase inhibitor, Immunologic diseases. Allergy, RC581-607
More Details: 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.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1742-6405
Relation: https://doaj.org/toc/1742-6405
DOI: 10.1186/s12981-023-00554-8
Access URL: https://doaj.org/article/40a30e66ce484da790091052d8194380
Accession Number: edsdoj.40a30e66ce484da790091052d8194380
Database: Directory of Open Access Journals
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More Details
ISSN:17426405
DOI:10.1186/s12981-023-00554-8
Published in:AIDS Research and Therapy
Language:English