帕博利珠单抗相关的非小细胞肺癌患者重度血小板减少症：病例报告及文献复习。
Severe Thrombocytopenia Associated With Pembrolizumab in Patients With Non-small Cell Lung Cancer (NSCLC): A Case Report and Literature Review.
机构信息
Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama University Hospital, Saitama, Japan.
Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama University Hospital, Saitama, Japan
出版信息
In Vivo. 2020 Mar-Apr;34(2):877-880. doi: 10.21873/invivo.11852.
BACKGROUND/AIM: Thrombocytopenia, one of many immune-related adverse events (irAEs), is a rare entity about which little is known on its treatment, outcomes, and patient demographics. Herein we present a case of severe thrombocytopenia after administration of pembrolizumab as an anti-programmed death-1 (PD-1) antibody.
CASE REPORT
A 66-year-old man with advanced non-small cell lung cancer (NSCLC) received pembrolizumab; 21 days later, his platelet count was progressively decreased and he experienced severe thrombocytopenia (grade 4; platelet count 0.4×10/l). With oral steroids 1 mg/kg/day, the platelet count improved sufficiently; thus, a definite diagnosis of severe irAE-related thrombocytopenia was performed.
CONCLUSION
Several reports have described the management and occurrence of severe thrombocytopenia after immune checkpoint inhibitor administration in patients with different neoplasms. Physicians should be alert to the potential of rare irAEs, such as severe thrombocytopenia.
背景/目的：血小板减少症是众多免疫相关不良事件（irAEs）之一，关于其治疗、结局和患者人群特征的了解甚少。在此，我们报告了一例接受抗程序性死亡-1（PD-1）抗体 pembrolizumab 治疗后发生严重血小板减少症的病例。
病例报告
一名 66 岁男性患有晚期非小细胞肺癌（NSCLC），接受 pembrolizumab 治疗；21 天后，其血小板计数逐渐下降并发生严重血小板减少症（4 级；血小板计数 0.4×10^9/L）。给予 1 mg/kg/日的口服皮质类固醇治疗后，血小板计数得到充分改善；因此，明确诊断为严重 irAE 相关血小板减少症。
结论
有几项报告描述了不同肿瘤患者接受免疫检查点抑制剂治疗后发生严重血小板减少症的管理和发生情况。医生应警惕罕见的 irAEs（如严重血小板减少症）的发生。
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