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中国全科医学

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一例弥漫大B细胞淋巴瘤合并重度肾功能不全患者的治疗与分析

刘婧琳1，2，李维2，3，宋晓坤1，2，张洁1，2*   

  1. 1.300060 天津，天津医科大学肿瘤医院药学部；2.300060 天津，国家恶性肿瘤临床医学研究中心/天津市恶性肿瘤临床医学研究中心/乳腺癌防治教育部重点实验室/天津市肿瘤防治重点实验室；3.300060 天津，天津医科大学肿瘤医院淋巴瘤内科
  • 收稿日期:2025-02-17 接受日期:2025-03-27
  • 通讯作者: 张洁
  • 基金资助:
    天津市重点学科（专科）建设项目(No. TJYXZDXK-009A); 天津医科大学肿瘤医院科研项目药学、检验、影像专项基金(No. Y2205)

Treatment and Analysis of a Patient with Diffuse Large B-Cell Lymphoma Complicated by Severe Renal Insufficiency　

LIU Jinglin1，2，LI Wei1，2，SONG Xiaokun1，2，ZHANG Jie1，2*   

  • Received:2025-02-17 Accepted:2025-03-27
  • Contact: ZHANG Jie
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摘要： 目的　探讨弥漫大B细胞淋巴瘤（DLBCL）合并急性肾衰竭患者治疗服务模式，以建立有效防治措施。方法　分析1例晚期弥漫大B细胞淋巴瘤继发急性肾衰竭患者使用维泊妥珠单抗联合免疫化疗临床资料，探讨病因、预后评估、治疗可行性、肿瘤溶解综合征风险评估管理、治疗方案的调整、药学监护要点分析、透析时机的把握等。结果　患者治疗过程平稳，未发生肿瘤溶解综合征，经过2周期治疗后，肿瘤压迫症状减轻，急性肾损伤得到有效缓解，乳酸脱氢酶水平趋于正常。结论　弥漫大B细胞淋巴瘤合并肾功能不全患者的个体差异较大，临床治疗方案应在明确检查、全面评估的基础上进行个体化治疗。医生与药师应加强沟通，保障治疗安全有效。

关键词: 弥漫大B细胞淋巴瘤, 急性肾衰竭, 剂量调整, 透析, 肿瘤溶解综合征

Abstract: Objective　 To explore the treatment service model for patients with diffuse large B - cell lymphoma complicated by acute renal failure, so as to establish effective preventive and treatment measures. Methods　Analyze the clinical data of a patient with advanced diffuse large B-cell lymphoma complicated by acute renal failure who received polatuzumab vedotin combined with chemotherapy. Explore the etiology, prognostic assessment, treatment feasibility, risk assessment and management of tumor lysis syndrome, adjustment of treatment regimens, key points of pharmaceutical care analysis and determination of dialysis timing, etc. Results　The patient's treatment process was stable, and no tumor lysis syndrome occurred. After 2 cycles of treatment, the symptoms of tumor compression were relieved, acute renal failure was effectively alleviated, and the lactate dehydrogenase level tended to be normal. Conclusion　There are significant individual differences among patients with diffuse large B-cell lymphoma complicated by renal failure. The clinical treatment regimens should be individualized based on clear examinations and comprehensive assessments. Doctors and pharmacists should strengthen communication to ensure the safety and effectiveness of treatment.

Key words: Diffuse large B-cell lymphoma, Acute renal failure, Treatment adjustment, Dialysis, Tumor lysis syndrome

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