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免疫检查点抑制剂相关的心脏毒性:病例系列及文献综述

Cardiac Toxicity Associated with Immune Checkpoint Inhibitors: Case Series and Review of the Literature.

作者信息

Agrawal Nikhil, Khunger Arjun, Vachhani Pankit, Colvin Teresa A, Hattoum Alexander, Spangenthal Edward, Curtis Anne B, Dy Grace K, Ernstoff Marc S, Puzanov Igor

机构信息

Department of Medicine, Jacobs School of Medicine and Biomedical Sciences<bold></bold> at the University at Buffalo, Buffalo, New York, USA.

Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

Case Rep Oncol. 2019 Mar 21;12(1):260-276. doi: 10.1159/000498985. eCollection 2019 Jan-Apr.

Abstract

The development of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of patients with advanced stage cancers. However, immune-related adverse events are frequently observed. Cardiac toxicity from ICI therapy can range from asymptomatic troponin-I elevations to conduction abnormalities of the heart and even fulminant myocarditis. Although rare, myocarditis is a potentially fatal adverse effect of ICI therapy. We present a series of five cases of ICI-related cardio-toxicity diagnosed and managed at Roswell Park Comprehensive Cancer Center along with a review of published case reports in the literature. Our series highlights the importance of high clinical suspicion, early diagnosis of myocarditis, and prompt initiation of immunosuppressive therapy.

摘要

免疫检查点抑制剂(ICI)的发展彻底改变了晚期癌症患者的治疗方式。然而,免疫相关不良事件却屡见不鲜。ICI治疗引起的心脏毒性范围广泛,从无症状的肌钙蛋白I升高到心脏传导异常,甚至爆发性心肌炎。心肌炎虽罕见,但却是ICI治疗潜在的致命不良反应。我们报告了罗斯威尔公园综合癌症中心诊断和处理的5例与ICI相关的心脏毒性病例,并对文献中已发表的病例报告进行了综述。我们的系列病例突出了高度临床怀疑、心肌炎早期诊断以及及时启动免疫抑制治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ad8/6465686/87610346e5f1/cro-0012-0260-g01.jpg

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