Department of Neurology, University of Chicago Medical Center, Chicago, IL 60637, USA.
Immunotherapy. 2021 Jan;13(1):11-17. doi: 10.2217/imt-2020-0186. Epub 2020 Oct 6.
Neurological immune-related adverse events (irAEs) are rare toxicities that occur following immune checkpoint inhibitor therapy. We propose that patients with thymic malignancies and graft-versus-host disease (GVHD) are predisposed to irAEs. We present two asymptomatic patients, one with thymoma and another with GVHD, who developed abnormal brain MRIs after treatment with programmed cell death protein 1 inhibitors. The first patient, with thymic cancer and thymoma, developed pontine enhancing MRI lesions following treatment with pembrolizumab. The second patient, with prior GVHD, developed pachymeningeal enhancement following treatment with nivolumab. IrAEs with abnormal MRI studies, despite asymptomatology, have significant impact on the treatment strategy for these patients.
神经免疫相关不良事件（irAEs）是免疫检查点抑制剂治疗后罕见的毒性反应。我们提出，患有胸腺瘤和移植物抗宿主病（GVHD）的患者易发生 irAEs。我们介绍了两名无症状患者，一名患有胸腺瘤，另一名患有 GVHD，他们在接受程序性细胞死亡蛋白 1 抑制剂治疗后出现了异常的脑部 MRI。第一例患者患有胸腺癌和胸腺瘤，在接受 pembrolizumab 治疗后出现了桥脑增强 MRI 病变。第二例患者有既往 GVHD，在接受 nivolumab 治疗后出现了硬脑膜增强。尽管无症状，但伴有异常 MRI 研究的 irAEs 对这些患者的治疗策略有重大影响。
