Yamane Hiromichi, Ochi Nobuaki, Nagasaki Yasunari, Yamagishi Tomoko, Honda Yoshihiro, Nakagawa Nozomu, Takeyama Masami, Nakanishi Hidekazu, Takigawa Nagio
Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan,
Ther Clin Risk Manag. 2018 Aug 21;14:1457-1465. doi: 10.2147/TCRM.S169824. eCollection 2018.
Cure-oriented treatment of malignant lymphoma (ML) is possible even in an advanced stage; however, the progression of drug-induced interstitial lung disease (DILD) sometimes accounts for poor clinical outcomes. This study aims to assess the incidence and clinical characteristics of DILD among patients with ML and compares the serum level of Krebs von den Lungen-6 (KL-6) with that of circulating thymus and activation-regulated chemokine (TARC)/CC chemokine ligand 17 (CCL17) as a diagnostic biomarker for DILD.
Between July 2011 and August 2016, we enrolled 36 patients with ML who were undergoing systemic chemotherapy at our hospital. Then, we evaluated the serum concentration of KL-6 and TARC/CCL17 by a sandwich-type electrochemiluminescence immunoassay and enzyme-linked immunosorbent assay, respectively.
DILD developed in 22.2% of patients with ML. All patients recovered immediately after the discontinuation of causative drug and/or glucocorticoid therapy. Although the sensitivity of both TARC/CCL17 and KL-6 was almost equal, the mean concentration of serum KL-6 after the progression of interstitial lung disease was significantly higher than that before progression.
DILD developed in patients who were treated with first-line rituximab combined regimen. Remarkably, TARC/CCL17 and KL-6 seemed approximately equal as a predictive biomarkers for DILD; however, KL-6 was more specific than TARC/CCL17.
即使在晚期,恶性淋巴瘤(ML)的根治性治疗也是可能的;然而,药物性间质性肺病(DILD)的进展有时会导致临床预后不佳。本研究旨在评估ML患者中DILD的发生率和临床特征,并比较血清克雷伯斯-冯-登-卢根-6(KL-6)水平与循环胸腺和活化调节趋化因子(TARC)/CC趋化因子配体17(CCL17)水平,将其作为DILD的诊断生物标志物。
2011年7月至2016年8月期间,我们纳入了36例在我院接受全身化疗的ML患者。然后,我们分别通过夹心型电化学发光免疫分析法和酶联免疫吸附测定法评估了KL-6和TARC/CCL17的血清浓度。
22.2%的ML患者发生了DILD。所有患者在停用致病药物和/或糖皮质激素治疗后立即康复。虽然TARC/CCL17和KL-6的敏感性几乎相同,但间质性肺病进展后血清KL-6的平均浓度显著高于进展前。
接受一线利妥昔单抗联合方案治疗的患者发生了DILD。值得注意的是,TARC/CCL17和KL-6作为DILD的预测生物标志物似乎大致相同;然而,KL-6比TARC/CCL17更具特异性。