Royal Free Hospital, Pond Street, Hampstead, London, UK.
Melanoma Res. 2020 Jun;30(3):321-324. doi: 10.1097/CMR.0000000000000651.
We report a case in which a renal transplant recipient with metastatic melanoma had an excellent response to treatment with second line programmed cell death protein 1 (PD-1) inhibitor therapy, pembrolizumab. Acute cellular allograft rejection on initiation of PD-1 inhibitor was successfully reversed with methylprednisolone. By converting the patient to sirolimus and giving predose prednisolone, pembrolizumab was continued with stable renal function and an excellent oncological response. This case supports the efficacy of PD-1 inhibitors in patients who are chronically immunosuppressed, and suggests an approach to maintain transplant function.
我们报告了一例转移性黑色素瘤的肾移植受者，二线程序性死亡蛋白 1（PD-1）抑制剂治疗，pembrolizumab 治疗效果极好。PD-1 抑制剂起始时发生急性细胞性同种异体移植排斥反应，用甲基强的松龙成功逆转。通过将患者转换为西罗莫司并给予泼尼松预剂量，继续使用 pembrolizumab，同时肾功能稳定，肿瘤反应良好。该病例支持 PD-1 抑制剂在慢性免疫抑制患者中的疗效，并提出了一种维持移植功能的方法。
