血小板减少症的发生与接受免疫治疗的患者生存率提高有关。
Development of thrombocytopenia is associated with improved survival in patients treated with immunotherapy.
作者信息
Assi Hussein A, Asch Adam S, Machiorlatti Michael, Vesely Sara K, Ibrahimi Sami
机构信息
Division of Hematology/Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
Department of Biostatistics & Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
出版信息
Future Sci OA. 2020 Jun 25;6(7):FSO581. doi: 10.2144/fsoa-2020-0021.
BACKGROUND
Immune-related adverse events are associated with efficacy of immune checkpoint inhibitors (ICIs). We hypothesize that immune-mediated thrombocytopenia could be a biomarker for response to ICIs.
MATERIALS & METHODS: This retrospective study included 215 patients with metastatic malignancies treated with ICIs. Patients were stratified by nadir platelet count. Outcomes of interest were progression-free survival and overall survival.
RESULTS
On multivariate analysis, grade 1 thrombocytopenia was positively associated with overall survival compared with patients who did not develop thrombocytopenia (hazard ratio [HR]= 0.28 [95% CI: 0.13-0.60]; p = 0.001), while grade 2-4 thrombocytopenia was not (HR= 0.36 [95% CI: 0.13-1.04]; p = 0.060). There was no association between degree of thrombocytopenia and progression-free survival.
CONCLUSION
Follow-up studies are warranted to substantiate the predictive significance of thrombocytopenia in patients receiving ICIs.
背景
免疫相关不良事件与免疫检查点抑制剂（ICI）的疗效相关。我们假设免疫介导的血小板减少可能是ICI反应的生物标志物。
材料与方法
这项回顾性研究纳入了215例接受ICI治疗的转移性恶性肿瘤患者。患者按最低点血小板计数分层。感兴趣的结局是无进展生存期和总生存期。
结果
多变量分析显示，与未发生血小板减少的患者相比，1级血小板减少与总生存期呈正相关（风险比[HR]=0.28[95%置信区间：0.13 - 0.60]；p = 0.001），而2 - 4级血小板减少则不然（HR = 0.36[95%置信区间：0.13 - 1.04]；p = 0.060）。血小板减少程度与无进展生存期之间无关联。
结论
有必要进行后续研究以证实血小板减少在接受ICI治疗患者中的预测意义。
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