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Objective:To investigate the effect and safety of rituximab, programmed death 1 (PD-1) monoclonal antibody, and Bruton tyrosine kinase (BTK) inhibitor on elderly refractory primary central nervous system lymphoma (PCNSL).Methods:The clinical data of an elderly patient with refractory PCNSL treated with the combination of rituximab, PD-1 monoclonal antibody and BTK inhibitor in the First Hospital of Jilin University in February 2020 were retrospectively analyzed. The relevant literature was reviewed.Results:The patient had primary central nervous system diffuse large B-cell lymphoma (high-risk group), and the Memorial Sloan Kettering Cancer Center (MSKCC) score was 2 (estimated overall survival time was 7 months). Disease progressed after 1 course of treatment. Complete remission was achieved after the therapy of rituximab, PD-1 monoclonal antibody combined with BTK inhibitor. PD-1 monoclonal antibody maintenance therapy was performed and patient was followed up until November 17, 2021. The patient's condition was stable. The second progression-free survival (PFS) time was 20 months, and the overall survival time was 21 months. The patient well tolerated the new drug treatment, and no adverse reactions of grade 3 or above occurred.Conclusions:The new targeted combination therapy can be used as a treatment option for elderly PCNSL patients, which can further improve the curative effect and significantly improve the prognosis.
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Objective To detect the serum level of vitamin D in infants with atopic dermatitis (AD),and to investigate the relationship between the serum level of vitamin D and severity of AD in infants.Methods Clinical data were collected from patients with moderate to severe AD (AD group)through a questionnaire survey in Children's Hospital of Shanxi from February to April in 2016,and the severity of AD was evaluated by the SCORing atopic dermatitis (SCORAD) score.A total of 95 health checkup examinees served as the control group.Enzyme-linked immunosorbent assay (ELISA)was performed to detect the serum level of 25 (OH) D3 in the AD group and control group,as well as the total serum IgE level in the AD group.Blood cell analyzer was used to determine the proportion of blood eosinophils in the AD group.Results A total of 97 patients with AD were enrolled into the study,including 43 (44.3 ％) patients with moderate AD and 54 (55.7％) patients with severe AD.The serum level of 25 (OH) D3 was significantly lower in the AD group than in the healthy control group ([66.71 ± 21.07] nmol/L vs.[85.43 ± 14.87] nmol/L,P ＜ 0.01),as well as in the patients with severe AD than in the patients with moderate AD ([47.54 ± 29.36] nmol/L vs.[63.89 ± 26.67] nmol/L,P =0.006).The proportion of blood eosinophils was significantly higher in the severe AD group than in the moderate AD group (0.124 ± 0.094 vs.0.061 ± 0.060,P ＜ 0.001).There was no significant difference in the total serum IgE level between the moderate AD group and severe AD group (P =0.375).Among the patients with AD,the serum level of 25 (OH) D3 was negatively correlated with the proportion of blood eosinophils (r =-0.336,P ＜ 0.05),but there was no correlation between the serum level of 25 (OH)D3 and total serum IgE level (r =-0.174,P ＞ 0.05).The serum level of 25 (OH)D3 was significantly associated with breastfeeding and vitamin D supplementation (P ＜ 0.05),but unrelated to age,gender,course of disease and acute exudative phase (all P ＞ 0.05).Conclusion The serum level of 25 (OH) D3 is evidently decreased in infants with AD,and vitamin D deficiency is closely related to the severity of AD in infancy.